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The new workers’
compensation medical fee guidelines have been published.
Please click
here to see the proposed rules.
Orthopaedic
surgeons who treat injured workers should provide comments on the
rules as soon as possible via e-mail to this address:
rulecomments@tdi.state.tx.us and please bcc:
michael.reed@texmed.org
if you can.
Summary:
The Texas Department of Insurance - Division of Workers’ Compensation
is required to revise the fees paid to physicians every two years. The
last fee schedule adjustment occurred in 2003 when the fees were
reduced to 125% of Medicare. In October of 2007 proposed rules were
developed for revision to the medical fee guideline that would do the
following:
-
Create a new
medical fee guideline based on multiple conversion factors (surgical
codes paid on a separate conversion factor);
-
Current medical
fee guideline is equivalent to 125% of Medicare
-
Proposed
conversion factor for E&M codes is equivalent to 140% of Medicare (TMA
is requesting 155% of Medicare)
-
Proposed
conversion factor for Surgical codes is equivalent to 175% of
Medicare (TMA is requesting 190% of Medicare)
-
Adjust the medical
fee guideline annually according to the Medical Economic Index
(MEI);
-
Make incentive
payments equivalent to a 10% increase above what Medicare allows for
areas that are demonstrated access shortage areas (identified by zip
code)
Much advocacy effort has gone into
requesting the Division to increase fees to improve access and quality
issues in the workers’ compensation system, your response is needed.
There is a lot of resistance to these rules, so please respond. The
communication does not have to be formal, any response will help.
Again, to respond via e-mail the
address is:
rulecomments@tdi.state.tx.us
and please bcc:
michael.reed@texmed.org.
To
respond via
mail or courier please use this contact information:
Texas Department of
Insurance, Division of Workers' Compensation
Attention: Victoria Ortega
Legal Services, MS-4D
7551 Metro Center Drive, Suite 100
Austin, Texas 78744-1609
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