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2012 SESSION
12104091DBe it enacted by the General Assembly of Virginia:
1. That § 65.2-714 of the Code of Virginia is amended and reenacted as follows:
§ 65.2-714. Fees of attorneys and physicians and hospital charges.
A. Fees of attorneys and physicians and charges of hospitals
for services, whether employed by employer, employee or insurance carrier under
this title, shall be subject to the approval and award of the Commission. In addition
to the provisions of Chapter 13 (§ 65.2-1300 et seq.) of
this title, the Commission shall have exclusive
jurisdiction over all disputes concerning such fees or charges and may order
the repayment of the amount of any fee which has already been paid that it
determines to be excessive; appeals from any Commission determinations thereon
shall be taken as provided in § 65.2-706. The
Commission shall also retain jurisdiction over disputes
regarding, and claimants shall have standing to pursue payment
of, charges for medical
services notwithstanding that bills or parts of bills for health care services
may have been paid by a source other than an employer, workers' compensation
carrier, guaranty fund or uninsured employer's
fund. No physician shall be entitled to collect fees from
an employer or insurance carrier until he has made the reports required by the
Commission in connection with the case.
B. If a contested claim is held to be compensable under this title and, after a hearing on the claim on its merits or after abandonment of a defense by the employer or insurance carrier, benefits for medical services are awarded and inure to the benefit of a third party insurance carrier or health care provider, the Commission shall award to the employee's attorney a reasonable fee and other reasonable pro rata costs as are appropriate from the sum which benefits the third party insurance carrier or health care provider. Such fees shall be based on the amount paid by the employer or insurance carrier to the third party insurance carrier or health care provider for medical, surgical and hospital service rendered to the employee through the date on which the contested claim is heard before the Deputy Commissioner. For the purpose of this subsection, a "contested claim" is an initial contested claim for benefits and claims for medical, surgical and hospital services that are subsequently contested and litigated or after abandonment of a defense by the employer or insurance carrier.
C. Payment of any obligation pursuant to this section to any third party insurance carrier or health care provider shall discharge the obligation in full. The Commission shall not reduce the amount of medical bills owed to the Commonwealth or its agencies without the written consent of the Office of the Attorney General.
D. No physician, hospital, or other health care provider as defined in § 8.01-581.1 shall balance bill an employee in connection with any medical treatment, services, appliances or supplies furnished to the employee in connection with an injury for which an award of compensation is made pursuant to § 65.2-704. For the purpose of this subsection, a health care provider "balance bills" whenever (i) an employer or the employer's insurance carrier declines to pay all of the health care provider's charge or fee and (ii) the health care provider seeks payment of the balance from the employee.