PERAC Memo #7 - 2005: 840 CMR 10:10(3) and 10:15(4) – Annual Review of Medical Tests

840 CMR 10:10(3) and 10:15(4) – Annual Review of Medical Tests

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Summary

This memo confirms PERAC's annual determination under 840 CMR 10:10(3) and 10:15(4) regarding the cap on non-invasive medical test costs that Regional Medical Panels may order without prior Commission approval. PERAC voted to continue the existing practice of authorizing PERAC staff to approve such testing costs up to $100.00 per case. No action is required by retirement boards; this is provided for informational purposes as required by the regulation.

Full Text

Memorandum # 7/2005

M E M O R A N D U M

TO: All Retirement Boards

FROM: Joseph E. Connarton, Executive Director

RE: 840 CMR 10:10(3) and 10:15(4) – Annual Review of Medical Tests

DATE: January 26, 2005

CMR 10:10(3) and 10:15(4) state, “ the medical panel may suggest ‘non-invasive’ medical tests, which the panel considers necessary to render an opinion of the member’s medical condition. The Commission shall assume the cost of any non-invasive test suggested by the medical panel up to an amount that the Commission shall determine annually. This annual determination will be communicated to all retirement boards during the month of January. No test, the cost of which exceeds the annual amount determined by the Commission, shall be ordered or required by the medical panel without the advanced approval of the Commission”.

Currently reimbursements for medical services ordered by a Regional Medical Panel have not exceeded $100.00. Medical panel physicians conduct very few medical tests during the medical panel process. The member’s medical provider generally orders the necessary medical tests during the evaluation and treatment phase and provides this information to the Regional Medical Panel. The Regional Medical Panel physicians consider the results of the studies as part of the medical panel examination.

The Commission voted to continue the past practice of allowing PERAC staff to approve up to $100.00 per case for medical testing associated with the medical panel process.