PERAC Memo #17 - 2006: 840 CMR 10:10(3) and 10:15(4) – Annual Review of Medical Testing Fees
840 CMR 10:10(3) and 10:15(4) – Annual Review of Medical Testing Fees
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This memo addresses PERAC's annual review, required under 840 CMR 10:10(3) and 10:15(4), of the maximum reimbursement amount for non-invasive medical tests ordered by a Regional Medical Panel during disability evaluations. PERAC has voted to maintain the existing $100-per-case cap, which PERAC staff may approve without further Commission action. Boards need not take any action but should be aware that any test exceeding $100 requires advance Commission approval before the panel can order it.
Full Text
Memorandum # 17/2006
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 Testing Fees
DATE: March 6, 2006
840 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 annually. 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 advance approval of the Commission”.
Currently, reimbursements for medical services ordered by a Regional Medical Panel have not exceeded $100. 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 per case for non-invasive medical testing associated with the medical panel process.
If you have any questions, please contact PERAC’s Disability Unit at 617-666-4446, ext. 956.