Increases in Medicare from the year 2017 to this time now in 2024 drive up workers’ compensation costs
By Lonce Lamonte - November 21, 2024The California Workers’ Compensation Institute (the CWCI) reported early this week that the percentage of Medicare for professional services increased a little more than 17 percent from 2017 to right now in 2024.
The Official Medical Fee Schedule (OMFS) conversion factor thus increased a little more than 17 per cent.
This drove up the cost to treat injured workers.
Each section of the fee schedule uses rules to calculate payment and different inflation factors to update reimbursement rates under California’s workers’ compensation system.
Fee schedules for inpatient services, outpatient, ambulatory surgery centers, ambulance services, and durable medical equipment use Medicare’s inflationary factors. The inflationary factors for these sections have been lower than general economic inflation, the report said.
But adjustments to the conversation factors used to calculate fees for professional services, which CWCI said account for 53% of medical payments in the state’s workers’ compensation system, have not aligned with Medicare.
While Medicare suspended the use of the Medicare Economic Index as a measure of inflation in 2015 and adopted statutory changes set by Congress, California uses the Medicare Economic Index as mandated by the statute.
Lonce Lamonte, journalist, editor, adjustercom, lonce@adjustercom.com; copyright Lonce Lamonte and adjustercom with all rights reserved.
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