SB 161

Abstract

Under this Act, a provider of services under § 2118(a)(2)a.1. and 3. of Title 21 may not exceed the charges permissible under the fee schedule established by the Workers’ Compensation Oversight Panel for work-related injuries. And, this Act prohibits these providers of services from demanding or requesting any payments in addition to the charges authorized by this Act. It also requires these providers of services to adhere to health care practice guidelines and be subject to utilization review. In addition, this Act requires insurers to report any pattern of overcharging, excessive treatment, or other improper actions by a healthcare provider to the Division of Professional Regulation. Finally, this Act provides that if an insurer has a contractual arrangement with a medical provider governing the fees for medical services, the contract fees would apply. The fee schedule would apply only in the absence of any such contractual arrangement.