The Department of Industrial Relations  announced a reduction in Independent Medical Review and Independent Bill Review fees effective January 1, 2015. This is the second reduction in fees since the inception of the IMR/IBR program and will no doubt be good news to the workers’ compensation community. The following are the announced fee reductions.

IMR Fees – Any IMR application submitted on or after January 1, 2015 will be subject to the following fee schedule:

Standard IMRs Involving Non-Pharmacy Claims*
Fee effective April 1, 2014: $420 per IMR
Fee effective Jan. 1, 2015: $390 per IMR

Standard IMRs Involving Pharmacy Only Claims**
Fee effective April 1, 2014: $390 per IMR
Fee effective Jan. 1, 2015: $345 per IMR

IMRs Terminated or Dismissed Not Forwarded to a Medical Professional Reviewer:
Fee effective April 1, 2014: $160 per IMR
Fee effective Jan. 1, 2015: $123 per IMR

IBR Fees – Any IBR application submitted on or after January 1, 2015 will be subject to the following fee schedule:

Completed IBR
Fee effective April 1, 2014: $250 per IBR
Fee effective Jan. 1, 2015: $195 per IBR

Ineligible IBR Not Sent to Review***
Fee effective April 1, 2014: $50 per IBR
Fee effective Jan. 1, 2015: $47.50 per IBR

* A “non-pharmacy-only” IMR is an IMR where not all treatments in dispute fall under the service category, “pharmaceuticals.”
** A “pharmacy-only” IMR is an IMR where all treatments in dispute fall under the service category “pharmaceuticals.”
*** Sending an IBR to review means assigning and providing the complete file to a certified coding specialist with the expertise necessary to evaluate and render decisions on all line items in dispute.