The 2014 International Association of Industrial Accident Boards and Commissioners (IAIABC) Annual Conference in Austin offered a forum for regulators from around the country to discuss common issues and potential solutions. The IAIABC is an association of government agencies that administer and regulate their jurisdictions' workers' compensation acts.
At this year's conference, held Sept. 29-Oct. 2, regulators highlighted a variety of complex issues that they are currently facing. Among them were:
1. Hospital Fee Schedules. In states that do not have hospital fee schedules, the standard for payment is usually "reasonable and customary" charges. The question becomes, how do you determine what is reasonable? Providers push for billed charges to be the standard; however, payers feel that this is an unfair standard because it is significantly higher than what providers ultimately accept as payment. On the other hand, payers are pushing for paid charges to be the standard, but the providers argue that PPO contracts dictate much of this and those contracts are based on volume. If someone doesn't have a contract, they do not believe that they should get the benefit of that discount.
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