WORKERS COMP-FEE SCHEDULE
HB2840 would overhaul the Illinois workers’ compensation medical fee schedule beginning September 1, 2026. It would make the current fee-schedule provisions inoperative after August 31, 2026 and direct the Illinois Workers’ Compensation Commission to create new schedules for covered medical services, with separate geographic groupings for non-hospital and hospital services. The bill keeps the existing framework for billing, payment timing, interest on late payments, and limits on employee liability, but replaces the current methodology for setting maximum payments with a new system tied to Medicare-based benchmarks and annual CPI adjustments.
Under the bill, the Commission would establish and maintain fee schedules for hospital inpatient and outpatient care, emergency room and trauma services, ambulatory surgical centers, professional services, prescriptions filled outside licensed pharmacies, and dental services, with rates varying by region. For September 1, 2026, the Commission would calculate initial maximum fees using Medicare maximum fees and specified percentage thresholds, then adjust those fees annually by half of the Consumer Price Index-U increase. The bill also creates a petition process allowing interested persons to seek a higher fee if the scheduled amount would significantly limit access to quality health care in a particular specialty or geographic area.
HB2840 would amend Section 8.2 of the Workers’ Compensation Act and substantially change how Illinois sets workers’ compensation medical reimbursement rates. It would replace the existing fee-schedule structure after August 31, 2026 with a new Commission-administered schedule based on Medicare comparisons, regional classifications, and annual inflation adjustments, while preserving related provisions on billing, payment deadlines, interest penalties, and employee protections against balance billing. The bill would directly affect employers, insurers, health care providers, and injured workers by changing reimbursement levels and creating a formal mechanism to challenge rates that reduce access to care.
Based on the bill text and the absence of recorded committee testimony or votes, the available context suggests a neutral-to-supportive policy intent focused on updating an aging reimbursement system rather than a clearly partisan or highly contested proposal. The measure appears designed to modernize fee schedules and address access concerns through a petition process, indicating an effort to balance cost control with provider availability. Because there is no transcript or voting history provided, no firm conclusion can be drawn about broader legislative sentiment beyond the bill’s stated administrative and access-oriented goals.
The main point of contention is likely the level of reimbursement under the new Medicare-based fee schedule, especially for providers who may argue that the proposed caps are too low and could limit participation in workers’ compensation networks or reduce access to care in certain regions or specialties. Employers and insurers would likely favor the tighter, more standardized payment methodology because it could restrain costs, while providers may be concerned about regional disparities and the possibility that annual CPI adjustments will not keep pace with actual medical cost growth. The bill anticipates this dispute by allowing petitions to the Commission when a fee schedule would create a significant limitation on access to quality health care.