The implication of this bill is significant as it seeks to standardize and regulate the costs associated with medical treatment in the context of workers' compensation claims. By putting in place a concrete framework for how fees are calculated and adjusted, the bill aims to ensure that injured workers have streamlined access to appropriate medical care while controlling costs for employers and ultimately the state. This structured approach may help diminish variability in reimbursement rates across the state.
Summary
House Bill 3874 proposes amendments to Section 42-15-90 of the South Carolina Code of Laws concerning workers' compensation. Specifically, it empowers the commission to establish and adjust medical fee schedules that dictate maximum allowable payments for medical services provided by practitioners, excluding hospital services and outpatient treatment. The bill mandates that any adjustments to existing fee schedules occur annually and cannot exceed specified percentage changes established by federally funded programs.
Contention
One notable point of contention surrounds the extent of control vested in the commission regarding fee adjustments. Critics might argue that the bill could lead to disputes over the appropriateness of fees and whether the commission's decisions adequately reflect the realities of medical costs versus patient access. The provision allowing for expedited appeals to the Administrative Law Court for adjustments greater than ten percent also raises questions regarding judicial involvement in what some believe should primarily be an administrative function.