Effective July 20, 2005, amendments to the Illinois Worker’s Compensation Act prohibit providers from billing patients for medical care for work-related injuries, and after payment is received from the employer, from recovering the difference between the provider’s charge and the payment received.

The payment due from the employer is the lesser of the actual charges or the amount required under the Fee Schedule adopted by the Illinois Workers’ Compensation Commission for the dates of service. 820 ILCS 305/8. As of January 31, 2006, there was no Medical Fee Schedule in effect. Therefore, for all dates of service on or before January 31, 2006, the amount due from the employer, by default, is the actual billed charges.

On January 26, 2006, the Commission formally voted to adopt a Medical Fee Schedule, instructions and guidelines. After the vote, emergency rules were adopted and proposed rules were scheduled for public hearings on February 14, 2006, and February 22, 2006. The emergency rules and the Fee Schedule apply for all medical treatment rendered on or after February 1, 2006. The Medical Fee Schedule, and the instructions and guidelines are available in the "News" section on the Illinois Workers’ Compensation Commission's website (www.iwcc.il.gov), and can be accessed directly by clicking here. 

All providers should use this Medical Fee Schedule, and follow the instructions and guidelines when processing workers’ compensation claim payments for services rendered on and after February 1, 2006.

For further information, please contact Victoria R. Glidden or your regular Hinshaw attorney.

This alert has been prepared by Hinshaw & Culbertson LLP to provide information on recent legal developments of interest to our readers. It is not intended to provide legal advice for a specific situation or to create an attorney-client relationship.