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Average med-legal payment up 67% in Calif.

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California

The California Workers’ Compensation Institute reported Wednesday that average payments for all comprehensive medical-legal evaluations climbed 67% under the new fee schedule that was approved earlier this year, more than double the increase the state Division of Workers’ Compensation predicted.

“Initial data on the utilization and cost of California workers’ compensation medical-legal services under the revised Medical-Legal Fee Schedule that took effect in April indicate that the increase in med-legal payments has exceeded the 25% increase that was anticipated by the Division of Workers’ Compensation,” CWCI reported in a bulletin.

The increase in payments also exceeds the 22% preliminary estimate from the Workers’ Compensation Insurance Rating Bureau presented during an actuarial committee meeting in April showing overall medical-legal payments could increase to about $469 million per year from $384 million.

Qualified medical evaluators and agreed medical evaluators received their first pay raise in 15 years when the DWC approved the new fee schedule.

The new fee schedule changed payment formulas for evaluations and reports.

The new fee schedule combined those three levels of service into a single code paying a flat rate of $2,015, which includes the review of up to 200 pages of records. The reimbursement rate for reviewing additional records is $3 per page.

WorkCompCentral is a sister publication of Business Insurance. More stories here.

 

 

 

 

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