OFFICE OF FISCAL ANALYSIS

Legislative Office Building, Room 5200

Hartford, CT 06106 (860) 240-0200

http://www.cga.ct.gov/ofa

SB-376

AN ACT AUGMENTING THE FEE SCHEDULE FOR RADIOLOGY SERVICES UNDER THE WORKERS' COMPENSATION STATUTES.


OFA Fiscal Note

State Impact:

Agency Affected

Fund-Effect

FY 18 $

FY 19 $

Department of Administrative Services - Workers' Comp. Claims and Various State Agencies

GF&TF - Cost

At least 21,000

At least 21,000

UConn Health Ctr.

GF - Revenue Gain

5,000 - 13,000

5,000 - 13,000

Workers' Compensation Com.

WCF - Cost

Up to 22,000

None

Note: GF&TF=General Fund & Transportation Fund; WCF=Workers' Compensation Fund;

Municipal Impact:

Municipalities

Effect

FY 18 $

FY 19 $

All Municipalities

STATE MANDATE - Cost

Indeterminate

Indeterminate

Explanation

The bill will result in a cost to the state workers' compensation program of at least $21,000 annually from a 15% increase on certain radiology procedures.1 Currently, reimbursement for the procedures listed in the bill range from $403 to $851 per procedure. The actual cost will depend on the services utilized by injured employees. The bill may result in a cost to the state Workers' Compensation Commission of up to $22,000 in FY 18 to update the hospital and physician fee schedules to reflect the increased radiology reimbursement rates. Currently, an outside vendor updates the fee schedules on an annual basis. The cost will depend on whether the vendor can update the schedules as a matter of normal practice or if it is considered an additional update to comply with the time frames in the bill. The hospital fee schedule was updated as of April 1st and the physician fee schedule was updated as of July 1st.

There will be an annual revenue gain of between $5,000 and $13,000 for the University of Connecticut Health Center from increased radiology reimbursement for workers' compensation patients at the Health Center.

There will be a cost to municipal workers' compensation programs which will depend on the utilization of services by injured employees for self-insured plans. The cost to fully-insured municipal plans will be reflected in premiums for coverage effective after July 1, 2018.

The Out Years

The annualized ongoing fiscal impact identified above would continue into the future subject to the utilization of services by injured workers and any future impact on premiums for fully-insured municipalities.

1 Estimate is based on paid claims for radiology procedures listed in the bill for FY 16.