Bill > SB164

This bill amends Delaware's workers' compensation medical expense regulations by making a permanent one-time 3% increase in aggregate medical expenses specifically to correct reimbursement rates for Evaluation and Management (E&M) codes, which have fallen below the Centers for Medicare & Medicaid Services (CMS) rates. The bill modifies previous legislation that aimed to reduce workers' compensation medical expenses by 33% by January 31, 2017, and 20% by January 31, 2015, by adding an exception to the earlier cost reduction requirements. The change is intended to address a critical shortage of physicians willing to treat workers' compensation patients by ensuring that medical providers are more fairly compensated for evaluation and management services. The bill maintains the previous framework of using Medicare-based reimbursement scales (such as Resource Based Relative Value Scale or Diagnosis Related Groups) with geographical adjustments, while allowing this specific 3% increase to help attract and retain medical providers in the workers' compensation system. The amendment takes effect on January 31, 2026, providing a long-term solution to the reimbursement rate challenges.

Labor and Employment

https://legis.delaware.gov/BillDetail?LegislationId=142390