The Assembly Insurance Committee collectively agreed to fix a drawback in the law that permits double billing for surgical implants in California workers’ compensation cases. Senate Bill 959, authored by Ted Lieu, D-Torrance, would attend to the Medicare Plans fee schedule adopted in 2004 and California law, consents to for a 120 percent payment for medical costs and permits separate costs for material and hardware in spinal plants to be added upon the original costs.
Termed as “pass‐through,” this payment is regarded a double‐payment as it allows a hospital to pass along the cost of a device, instrumentation, or hardware, though the cost is officially taken into consideration when setting the repayment level.
Earlier this month, a study made by the California Workers’ Compensation Institute established that the extra payments enhanced the system’s cost by $67.5 million in 2010. According to a study, the dual reimbursement for such devices supplemented an average of $20,137 in fees to spinal procedures for 3,350 injured workers that year.
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