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Emergency Rules Filed On Implants, ASTCs

09 Jul, 2010 WorkersCompensation.com

                               Chicago, IL (CompNewsNetwork) - On July 6, 2010, emergency rules took effect that change the reimbursement method for implants and add accredited Ambulatory Surgical Care Facilities

(ASCFs) to the ASTC fee schedule.  The Commission filed the emergency rules with the Illinois Secretary of State for publication in the Illinois Register. Simultaneously, the Commission filed the same language to go through the normal rule-making process.

The amendment makes two changes to Section 7110.90:

1. It changes the reimbursement method for medical implants from 65% of normal charge to 25% over the manufacturer¹s invoice price less rebates, plus actual and customary shipping costs incurred for the implant.

2. It provides that Ambulatory Surgical Care Facilities (ASCFs) accredited by AAAASF, JCAHO, AAAHC are eligible for reimbursement under the ASTC fee schedule. Previously, the rule said the ASTC fee schedule applied only to Ambulatory Surgical Treatment Centers licensed by the Illinois Department of Public Health.

Treatment on or after 7/6/10 should be paid according to these new rules.

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