FINAL BILL REPORT

                 SHB 1352

                         C 159 L 93

                     Synopsis as Enacted

Brief Description:  Revising provisions for fee schedules for industrial insurance medical aid.

By House Committee on Commerce & Labor (originally sponsored by Representatives Veloria, G. Cole and Franklin; by request of Department of Labor & Industries).

House Committee on Commerce & Labor

Senate Committee on Labor & Commerce

Background:  The Department of Labor and Industries is authorized to adopt rules establishing fee schedules governing maximum payment for medical services provided to injured workers.  Medical providers covered by the schedules include physicians, hospitals, pharmacies, and other providers.  The department or self-insured employer may only pay those charges that conform to the fee schedule.

The schedules are based on approximately 14,000 Physicians' Current Procedural Terminology codes that are updated annually by the American Medical Association.  To change the fee schedule under the state's Administrative Procedures Act, the department must conduct a public hearing after giving 20 days notice of the hearing on the proposed rule changes.  The new rules may not become effective sooner than 30 days after the final rules are filed with the Code Reviser's Office.

Summary:  The requirements are changed for adopting medical fee schedules by the Department of Labor and Industries.  The fee schedules may be changed periodically at the discretion of the director, after consultation with interested persons.  The department must coordinate the schedules with other agencies for consistency and uniformity where possible.  The fee schedule must be made available.  The establishment of a fee schedule, except for the schedule's conversion factors, is not agency action or an administrative rule as defined in the Administrative Procedures Act.

Fees and medical charges relating to the treatment of injured workers must conform with the fee schedules the department establishes under the new procedures.

Technical changes are made in the references to medical bills and medical charges to conform with the new requirements for establishing fee schedules.

Votes on Final Passage:

House 64 33

Senate 46 0

Effective:  July 25, 1993