Claims of attorneys and physicians and for medical and related services — Approval.
Claims of attorneys and claims for medical services and for medicine and related benefits shall be subject to approval by the commission; provided however, that fees for physician services shall be set using relative value units from the current year resource based relative value system (RBRVS) as it is modified from time to time, multiplied by conversion factors to be determined by the commission in rule. Factors will be set for, at least, the following CPT code areas: medicine, surgery, physical medicine, radiology, anesthesia and pathology. The commission shall adopt rules for the annual adjustment of medical reimbursements. In cases where RBRVS units are not available or have no relation to industrial claims, relative value units for fees for physician services shall be determined by the commission.
Notes of Decisions
Rhodes v. Indus. Comm'n, 868 P.2d 467 (Idaho 1993).
· cites it 67× “Nonetheless, the Commission, on a split vote of 2-1, adopted the regulations restricting the amount of legal fees recoverable by an attorney representing injured workers, citing I.C. § 72-803 as its source of authority.”
Verdene Page v. McCain Foods, Inc., 316 P.3d 671 (Idaho 2014).
· cites it 24× “The Commission eventually held a hearing on the matter, on April 10, 2012, and in denying Berry’s motion it noted that, while instructive, “the contingent fee agreement is not determinative of the fees to be awarded by the Commission in an award of Idaho Code § 72-804 attorney…”
Curr v. Curr, 864 P.2d 132 (Idaho 1993).
· cites it 16× “§§ 72-804 and 72-210, “evince a general legislative scheme whereby attorney fee issues closely related to the substance of the workers’ compensation claims are to be resolved by the Industrial Commission.” Under I.C. § 72-803, the Commission has a duty to approve or disapprove…”
Brannon v. Pike, 737 P.2d 459 (Idaho 1987).
· cites it 20× “Pike filed a motion to dismiss for lack of jurisdiction over the subject matter, urging that the Industrial Commission has exclusive jurisdiction to decide this claim. The district court granted the motion to dismiss, holding that the Industrial Commission was vested with…”
Mancilla v. Greg, 963 P.2d 368 (Idaho 1998).
· cites it 8× “In Rhodes , the Court held that the Commission has the authority to administer I.C. § 72-803, and to issue regulations necessary to secure relief for injured workers and their families.”
Cheung v. Pena, 137 P.3d 417 (Idaho 2006).
· cites it 6× “Idaho Code § 72-803 “grants the Commission the authority to ‘approve’ claims for attorney fees.”
Williams v. Blue Cross of Idaho, 260 P.3d 1186 (Idaho 2011).
· cites it 2× “I.C. § 72-803 provides that “[ejlaims of attorneys and claims for medical services and for medicine and related benefits shall be subject to approval by the commission.”
Matter of Wilson, 911 P.2d 754 (Idaho 1996).
· cites it 2× “According to this criteria, an acceptable charge for medical services is one which is the "[p]rovider's reasonable charge for Medical Services furnished to industrially injured patients.”
Smith v. Payette Cnty., 671 P.2d 1081 (Idaho 1983).
· cites it 2× “Appellant also argues for attorney fees, I.C. §§ 72-803, 72-804. In light of our disposition of the substantive issues, we deny an award of attorney fees.”
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