What You Need to Know About the New Workers’ Compensation Fee Schedule
Changes to the workers’ compensation fee schedule were implemented in Delaware in 2016 in an attempt to cut costs by 33% with Delaware House Bill (HB) 373. The results of these changes are still being studied, but early reports suggest savings are not as great as expected, and may be resulting in lowered quality of care for patients. At Silverman, McDonald & Friedman, we help clients in and around Seaford, Wilmington and Newark with all of their workers’ compensation claims. Please contact us to schedule a consultation.
What is a fee schedule?
Regulators in Delaware have expressed concern about perceived overpricing for workers’ compensation claims and services. This pricing data, or fee schedule, is calculated by comparing actual claims with the pricing for similar claims paid through the Medicare program, and then capping payments accordingly. A decade ago, the fee schedule for Delaware was 123% above the average Medicare rate, and the state was fourth in the nation in worker’s compensation expenses.
Fiscal results and concerns
While the results may not have been as significant as legislators hoped, there is evidence of a more modest 11% decrease in costs. Additionally, compared to national workers’ compensation costs, Delaware is now in the 30’s. Not all this news is as sanguine as it first appears, based on a study released a year ago exploring whether changes in fee schedules result in providers reporting various services and injuries differently, either to expand access for patients or to receive higher compensation for their services. Even the comparison to Medicare pricing may be systematically flawed, given that program’s standardization for the country as a whole, rather than on a state-by-state basis.
Impact on workers in Delaware
Workers’ compensation claims are a vitally necessary part of modern industry and commerce, to protect worker’s physical health and legal rights. It is certainly not necessary that workers’ compensation claim costs be allowed to balloon unnecessarily; however, modest growth rather than incessant reductions seem to be more reasonable. Growth suggests that more workers are able to access care through the program, and that more employers are accurately reporting work-related injuries. Drastic cuts should not be made at the expense of accessibility for those in need. Since the passage of (HB) 373, there have been growing reports of victims needing to seek legal representation to ascertain that they were receiving the medical care and coverage needed for full recovery, as the workers’ compensation program is intended.
Our thorough and thoughtful Delaware workers’ compensation attorneys at Silverman, McDonald & Friedman are here to aid you through the claims process. Contact us by calling 302-888-2900 or filling out our contact form to schedule a free consultation with an experienced workers’ compensation lawyer in Wilmington, Newark or Seaford today.
Attorney Jeffrey S. Friedman joined Silverman, McDonald & Friedman in 2001. He graduated from Widener University School of Law, and is admitted to practice law in Delaware and Pennsylvania, and in several Federal Circuit courts. He areas of concentration include auto accident and workers’ compensation cases. Read more about Attorney Friedman here.