HB3559 Summary

• Existing medical fee schedules become inoperative after August 31, 2022, requiring the Illinois Workers' Compensation Commission to establish new fee schedules effective September 1, 2022.

• New fee schedules use 4 non-hospital geographic regions and 14 hospital geographic regions based on county groupings throughout Illinois, with fee amounts tied to Medicare maximum fees at specified percentage levels (125%-300% depending on the Medicare percentage amount).

• Initial workers' compensation maximum fees are determined by calculating the Medicare percentage amount for each CPT and DRG code, with adjustments made based on tiered thresholds (ranging from 125% to 428.57% of Medicare rates).

• Starting September 1, 2023 and annually thereafter, the Commission adjusts all workers' compensation maximum fees by exactly half of the annual Consumer Price Index-U increase.

• Allows petitions to the Commission to modify fee schedules if they create significant limitations on access to quality health care in specific service fields or geographic areas, with the petitioner bearing the burden of proof using empirical data.