On July 1, 2014, new laws go into effect in Virginia to address medical provider billing in state workers' compensation cases. The changes include additions to Virginia Code Section 65.2-605 which limit the amount that medical providers may charge for the services of nurse practitioners, physician's assistants and assistant surgeons during surgery. Additionally, the changes limit the ability of physicians to bill separately for multiple surgical procedures completed on a single surgical site.
New rules were also added to assist in the collect payments and resolution of billing disputes in a timely manner. Virginia Code Section 65.2-605.1 requires payment within 60 days after receipt of an itemized billing, but allows the employer or carrier to contest the bill if notice is given within 45 days after receipt of the itemized billing, provided that the notice contains certain detailed information. Payments not timely made or contested are subject to interest at the judgment rate of interest. The new rules also provide a one year window for carriers to seek recovery of payments made to health care providers and for medical providers to challenge the sufficiency of payments made.
