4123-6-08 Bureau fee schedule.  

  • Text Box: ACTION: Final Text Box: DATE: 04/20/2016 12:11 PM

     

     

     

    4123-6-08                    Bureau fee schedule.

     

     

     

    (A)   Pursuant to division (A)(8) (A)(1)(h) of section 4121.441 of the Revised Code, the administrator of workers' compensation, with the advice and consent of the bureau of workers' compensation board of directors, shall develop, maintain, and publish a provider fee schedule for the various types of billing codes. The administrator hereby adopts the fee schedule indicated in the appendix A to this rule, developed with provider and employer input, effective January 1, 2015 2016.

     

    (B)    Whether the MCO has elected to retain a provider panel or not, an MCO may contract with providers. Every provider contract shall describe the method of payment to the providers. The MCO shall provide an MCO fee schedule to each provider that contracts with the MCO. The MCO fee schedule may be at different rates than the bureau fee schedule. The MCO shall make the MCO fee schedule available to the bureau as part of its application for certification. The bureau shall maintain the MCO fee schedule as proprietary information.

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    4123-6-08                                                                                                                              2

    Effective:                                                             05/01/2016

    Five Year Review (FYR) Dates:                         02/01/2020

    CERTIFIED ELECTRONICALLY

    Certification

    04/20/2016

    Date

    Promulgated Under:                           119.03

    Statutory Authority:                           4121.12, 4121.121, 4121.30, 4121.31, 4123.05

    Rule Amplifies:                                  4121.12, 4121.44, 4121.441, 4123.66

    Prior Effective Dates:                         2/16/96, 1/1/01, 2/19/09, 11/8/09, 10/25/10; 12/30/10,

    (Emer.), 3/21/11, 12/30/11 (Emer.), 3/24/12, 12/27/12, (Emer.), 3/24/13, 12/30/13 (Emer.), 3/28/14, 12/30/14,

    (Emer.), 1/15/15 (Emer.), 5/1/15, 12/31/15 (Emer.)

Document Information

Effective Date:
5/1/2016
File Date:
2016-04-20
Last Day in Effect:
2016-05-01
Rule File:
4123-6-08_PH_FF_A_RU_20160420_1211.pdf
Related Chapter/Rule NO.: (1)
Ill. Adm. Code 4123-6-08. Bureau fee schedule