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ISMS-Backed Workers’ Compensation Legislation Clears Important Committee Vote
Posted on: 5/24/2018

Workers' compensation

We are pleased to report important progress on ISMS-backed pro-physician workers' compensation legislation. Physicians who treat workers' compensation patients are facing a crisis over workers' compensation insurance companies failing to follow Illinois work comp law.

House Amendment 2 to Senate Bill 904 makes three changes to the Illinois Workers' Compensation Act in order to address a growing crisis of unpaid workers’ compensation medical bills. It would:

  • Allow medical professionals to collect interest on late medical claims by filing a claim for this interest in circuit court, and increase that late payment penalty from 1 percent to 2 percent. While this interest provision has been in the law since 2005, medical professionals currently have no means to collect this interest.
  • Require workers' compensation insurance companies to send an Explanation of Benefits to medical professionals explaining why they have denied the authorization of medical care or what additional information they need to make a decision on that care.
  • Prevent workers' compensation insurers from ignoring the law requiring them to use electronic billing for workers’ compensation claims. This has been the law for seven years, yet workers’ compensation insurers still refuse to use standardized electronic billing systems that are used throughout the rest of the health care world.

More and more doctors, hospitals and other medical professionals are finding it difficult to provide care to injured workers under the current climate. Any reduction in access to medical care will increase the time that injured workers are off of work and increase the long-term effects of their injuries – both of which could actually increase costs for employers, in addition to the negative effects on workers.

General Assembly clears these priority bills, which will be sent to the governor

  • Refills for non-controlled substances  

Senate Bill 3170 has passed out of the Illinois Senate and House. This legislation would extend the time a patient can refill a prescription for a non-controlled substance from 12 months to 15 months.  

  • Allowing ambulatory surgical treatment facilities to file liens

House Bill 4911 has cleared both the Illinois House and Senate. This ISMS-backed legislation would amend the Health Care Services Lien Act to allow ambulatory surgical treatment facilities (ASTFs) to file liens.

Under current law, only health care professionals and licensed medical institutions (hospitals, home health agencies, and ambulatory surgical treatment centers [ASTCs]) are able to file liens. ASTFs are typically physician-owned facilities that do not qualify for state licensure because of their size, but are nationally accredited.

  • Limited direct access for physical therapists

Prior to any negotiations, House Bill 4643 would have allowed physical therapists unfettered direct access with no physician involvement. ISMS successfully negotiated with the physical therapists to provide limited direct access and retain physician involvement, referral and medical diagnosis with regard to physical therapy services. The amended bill passed both the Illinois House and Senate.

As the spring 2018 legislative session continues, ISMS will keep you informed with Physician Advocate and the Legislative Action Hub

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