HB4079 Summary

• Establishes new medical fee schedules effective September 1, 2024, making existing schedules inoperative after August 31, 2024.

• Sets workers' compensation maximum fees based on Medicare maximum fees adjusted by specified percentages ranging from 125% to 300% depending on the Medicare percentage amount for each CPT and DRG code.

• Requires the Commission to establish an evidence-based drug formulary by September 1, 2023, limiting workers' compensation prescriptions to formulary drugs and doses, with one-time 7-day supplies permitted without preauthorization.

• Establishes rules for custom compound medications, requiring they meet FDA standards and be preauthorized by the employer for supplies longer than 7 days.

• Allows petitions to modify fee schedules if they create significant limitations on access to quality health care, with the Commission taking final action within 180 days.