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17
Sep 2019

IWCC Publishes Proposed Rules Defining “Explanation of Benefits”

By Joseph Gregorio     

  On September 13, 2019, Illinois Workers’ Compensation Commission published proposed rule changes in the Illinois Register.  The proposed rule changes implement the rulemaking required by Public Act 100-1117, defining what documents qualify as an explanation of benefits, and what information must be included to properly deny a medical bill. The proposed rule changes are
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05
Sep 2019

Generic Lyrica option now available on the CMS WCMSA submission portal

By Rasa Fumagalli     

  Pregabalin, the generic for Lyrica, became available in July of 2019. Despite the availability of Pregabalin, the WCMSA submission portal up until recently did not reflect the updated Pregabalin AWP pricing. At this time, the lowest non repackaged Red Book AWP for pregabalin 50mg capsules amounts to $0.90 per unit. Since the lowest non
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20
Aug 2019

Spoliation of Evidence: Unintended Consequences, What Else Now?

By Martha Gely-Kruto     

  One of the under the radar unintended consequences of Workers’ Compensation claims is spoliation of evidence. We don’t talk about it often and sometimes we don’t even know what it is, but it can definitely have a huge impact on a workers’ compensation claim. Spoliation of evidence is the loss or destruction of evidence
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06
Aug 2019

Dem Bones

By Lisa Azoory-Keller     

  “Dem Bones” (also known as “Dry Bones”) is a biblical song, inspired by Ezekiel’s visits to the Valley of Dry Bones. In Ezekiel’s vision, the dry bones are connected into human figures, and the prophet is commanded to revitalize the figures. According to the catchy tune, the hip bone is connected to the backbone,
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16
Jul 2019

Updated Status of Commission Rules Concerning EOBs

By Amy Bilton and James A. Moran     

  Our office recently received several questions regarding the proposed Explanation of Benefits (“EOB”), as well as the current Department of Insurance Rules concerning electronic billing in Workers’ Compensation claims.  Amy Bilton, a co-author of this blog post, serves on the Illinois Workers’ Compensation Medical Fee Advisory Board, and was part of the task force
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