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Peer Medical Consultants
Illinois utilizes physician consultants that review medical services records and make recommendations to our Peer unit as to quality of care, excess of needs, and risk of harm. Some of these recommendations may result in termination of the provider from the Medical Assistance Program. The provider has the right to appeal before termination. That appeal would go to an evidentiary hearing where the physician consultant would testify. We are asking if other states have medical consultant contracts, what is the pay rate, do you contract for each consultant separately or contract with an agency that provides all contractors for a flat fee or scale. Can you explain your fee structure for either contract type? Thank you!
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3 Replies
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Lisa,
I am Jennifer Ellingsen with Florida MPI. If you want to contact me, I can discuss with you how we handle our peer contracts. My email address is jennifer.ellingsen@ahca.myflorida.com or by phone at 850-412-4617. I will be happy to help you.
Jennifer
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Lisa, in FL we have about 14 peer consultants under individual contracts. We have ranges for pay based on the need.
For Physician Record Reviews we pay anywhere between $125 and $250 per hour
For our expert witnesses we pay between $150 and $450 per hour (with one physician contracted at $550 p/hr).
For our BACB-Ds we pay $125-$175 p/hr for record reviews and $175-$300 p/hr for expert witnesses.
If you have additional questions I saw that Jennifer responded below and it’s her team who generally negotiates the contracts. She may have more information for you.
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@Maureen Barker – Can you tell me what BACB-D stands for?
Thanks,
MaryKay Cary (New Jersey, marykay.cary@osc.nj.gov)
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