Jon Campisi’s June 2023 article in Business Insurance, titled “Medicare Pricing Changes Could Cost Comp”, discusses how the recent update in Medicare’s reimbursement rates by the Centers for Medicare & Medicaid Services (CMS) may impact workers’ compensation medical fee schedules and insurance rates.

The extent of the impact on workers’ compensation will differ across states. States with compensation medical fee schedules based on Medicare will automatically incorporate the changes, while others might use them as benchmarks. However, as NCCI actuary Jon Sinclair highlights, some states might ignore CMS’s rates completely when setting their own rates.

Immediate effects on insurance rates due to the CMS updates remain uncertain, as highlighted by Steve Bennett from the American Property Casualty Insurance Association.

New York’s workers’ compensation system is an example where the CMS updates do not directly affect the rate settings. The New York State Workers’ Compensation Board considers CMS data only one among several factors when periodically updating its fee schedules.
In California, while other factors impact the rates, CMS rate changes can directly affect the cost of medical care in workers’ compensation.

Don’t let work-related injuries or accidents put your life on hold! Despite safety measures in place, mishaps can still occur. At McIntyre, Donohue, Accardi, Salmonson, & Riordan, LLP, we understand the complexities of worker’s compensation, and we’re here to champion your case. With our expert legal team by your side, you can focus on recovery while we fight for your rights. Ready to take control? Give us a call at 866.557.7500