The Workers Compensation Commission has begun a review of proposed changes to the Medical Services Providers Manual, which they are required to renew annually. The changes will be in effect April 1, 2021; the proposed changes are in the Updates/News section of the SCWCC website. Below are some of the highlights.
Providers are required to include supporting documentation when submitting claims, or when required by an insurance carrier, self-insured employer, or the Commission to submit substantiating documentation, and may not charge for these required reports. However, when the records or reports are not for the purposes listed above, providers may charge for copying costs. Copying charges are $0.65 per page for the first 30 pages provided in electronic format, and $0.50 per page thereafter provided in an electronic format, which may not exceed $150.00 per request, plus a clerical and handling fee of $25.00 plus tax and actual postage costs.
Copying charges are $0.65 per page for the first 30 printed pages, and $0.50 per printed page thereafter, which may not exceed $200.00 per request, plus a clerical and handling fee of $25.00 plus tax and actual postage costs. Providers must respond to a request for copies within 14 days of receipt or face a penalty of up to $200.00.
Telemedicine is specifically addressed in the proposed changes for 2021 and will continue to be an acceptable form of medical treatment until at least 3/31/2022, depending on the status of the COVID 19 pandemic. There are some requirements placed upon the requisite qualifications of telemedicine providers and in most cases, pre-authorization may be required.
There were also proposed changes to billing guidelines for compound drugs as well as anti-inflammatory medications or local anesthetic single agents.
These and other proposals are more detailed in the information provided by the Commission. I strongly suggest that anyone interested in reviewing the proposed changes do so directly as this is not intended to be a detailed analysis of all changes to the current fee schedule being contemplated by the Commission.