HB3452 Summary

• Amends the Workers' Compensation Act Section 8.2 contingent on Senate Bill 904 of the 100th General Assembly becoming law in its passed form as of May 31, 2018.

• Modifies medical fee schedule payment calculations, changing the maximum allowable payment from 90% of the 80th percentile to 70% of fee schedule amounts for procedures, treatments, services, or supplies rendered on or after September 1, 2011.

• Establishes four geographic regions for non-hospital fee schedules and fourteen regions for hospital fee schedules, with Cook County, collar counties, southwestern Illinois counties, and all other counties having different reimbursement rates.

• Sets reimbursement at 25% above net manufacturer's invoice price for implants and 65% of actual charge for non-implantable devices; prescriptions filled outside pharmacies capped at Average Wholesale Price plus $4.18 dispensing fee.

• Requires payment to providers within 30 days of complete bill receipt and establishes 1% monthly interest charges for late payments, with providers able to seek collection from employees only in specific circumstances involving disputed compensability.