WCC Posts RFP for Medical Fee Schedules
September 1, 2025
The Workers' Compensation Commission has posted a Request for Proposals (RFP) for Updating the “Official Connecticut Fee schedule for Hospitals and Ambulatory Surgical Centers” and the “Official Connecticut Practitioner Fee Schedule”.
UPDATE: September 19, 2025
The Workers' Compensation Commission received a total of 17 questions related to RFP 2025 WCC Medical Fee Schedules. The questions and answers are outlined below:
1. Question: Will the Commission provide a contact list of prior purchasers for purposes of marketing the fee schedules?
Answer: No, WCC does not maintain a list of prior purchasers of fee schedules.
2. Question: On page 9, the RFP includes sections on financial and budget expectations. Please clarify the state’s expectations for responses to these sections. For example, what, if any, are the state’s insurance requirements for this engagement? Are you looking for responses related to budget expectations?
Answer: Please see the clarification for each item below. For some of these, an acknowledgement may suffice as meeting WCC’s expectations. WCC wants to ensure the selected vendor complies with Generally Accepted Accounting Principles (GAAP).
5. Financial Expectations
- Financial Control Procedures = WCC expects the selected Vendor will have proper financial controls in place which abide by Federal and State laws, rules, and regulations, and meet industry standards.
- Financial Status Reports = WCC expects the selected Vendor will provide financial status reports as determined appropriate in the final contract and subject to Federal and State laws, rules, and regulations.
- Audited Financial Statements = WCC expects the selected Vendor will provide audited financial statements as determined appropriate in the final contract and subject to Federal and State laws, rules, and regulations.
- Insurance Requirements = WCC expects the selected Vendor will abide by all Federal and State insurance requirements and provide documentation as appropriate under terms of the final contract.
6. Budget Expectations
- Cost Standards = WCC expects the selected Vendor to apply appropriate cost standards.
- Funding Sources = WCC expects the selected Vendor to understand WCC is an industry funded agency not subject to the Connecticut General Fund. Funding comes from the State’s Workers’ Compensation Fund.
- Total Available Funding = WCC expects the selected Vendor to understand WCC is limited in its total available funding for services under this RFP as provided under the biennial state budget.
- Period of Award = WCC expects the selected Vendor to understand and agree to the period of award outlined in the RFP.
- Proration = WCC expects the selected Vendor to understand that funding may be withheld or prorated subject to the final contract if services are not delivered as agreed.
- Flat Fees = WCC expects the selected Vendor to disclose any flat fees anticipated under the contract, if applicable.
- Fee-for-Service Revenues = WCC expects the selected Vendor to disclose any fee for services anticipated under the contract if applicable.
3. Question: Does the WCC maintain the final determination and decision authority for the maximum allowable charges (dollar amount), per CPT Code, contained in the Fee Schedules?
Answer: Yes, final determination of charges is granted to the Chairperson of WCC pursuant to C.G.S. § 31-280 (b)(B) and C.G.S. § 31-294 (e).
4. Question: Given that Connecticut General Statutes Annotated § 31-280(b)(15) allows the WCC to “Enter into contracts with consultants and such other persons as necessary for the proper functioning of the commission,” does the ultimate responsibility to “establish, publish and update” the Fee Schedules stay with the WCC?
Answer: Yes, the Workers’ Compensation Act requires the WCC to establish, publish, and update the Fee Schedules. Use of contracted vendors to accomplish this is permissible under C.G.S. Sec. 31-280(b)(15).
5. Question: Does the WCC consider the Fee Schedules to be “public records or files” as defined by Connecticut General Statutes Annotated § 1-200(5).
Answer: Aspects of the fee schedules, including narratives, may be subject to the Connecticut Freedom of Information Act and considered public records or files under C.G.S. § 1-200(5). However, C.G.S. § 1-210 (b)(5) may exempt certain data and information contained within the fee schedule from disclosure.
6. Question: Does the WCC anticipate that the Fee Schedules will be available to inspect/copy/receive a copy by public persons, as contemplated by Connecticut General Statutes Annotated § 1-210(a)?
Answer: The public may be allowed to inspect/copy/receive certain aspects of the Fee Schedules, such as the narrative portions.
7. Question: Does the WCC anticipate the Vendor maintaining efforts to protect the secrecy of Fee Schedules?
Answer: No, WCC does not require the Vendor to maintain efforts to protect the secrecy of Fee Schedules.
8. Question: Does the WCC anticipate the Contract with the Vendor to contain any language that would restrict the access of public persons to inspect/copy/receive a copy of any portion of the Fee Schedules?
Answer: This will be considered as part of contract negotiations, but any language must ensure there are no restrictions to portions of the Fee schedules which are not exempt under the Connecticut Freedom of Information Act. There should also be no restrictions on who can purchase the fee schedule.
9. Question: Does the WCC anticipate the Contract with the Vendor to create or grant a completely exclusive distribution right of the Fee Schedules to the Vendor?
Answer: Given the nature of the requested services, WCC anticipates exclusive distribution rights to the Vendor being considered as a part of contract negotiations.
10. Question: Pursuant to the RFP (II. Purpose of RFP and Scope of Services, C. Scope of Service Description, 2. Service Expectations, 9.), the Vendor must “Agree that all charges for the sale of the Annual Updates to third parties must be at a rate agreeable to the Agency and Vendor.” Please confirm what the maximum possible “rate agreeable” would be.
Answer: The rate agreeable to the Agency and Vendor will be considered as part of contract negotiations and subject to a potential increase from past rates, should the selected vendor provide valid and appropriate justification for such an increase.
11. Question: Beyond the one-time “rate agreeable to the Agency and Vendor” to be charged to third parties for the purchase/distribution of the Fee Schedules, does the WCC anticipate the Vendor placing any other restrictions for the purchase of the Fee Schedules on third parties (i.e. terms and conditions and/or license agreements)?
Answer: Given the nature of the fees schedule and data within, WCC would anticipate the vendor selected potentially placing other restrictions for the purchase of fee schedules such as terms and conditions and/or license agreements as permitted under State and Federal law.
12. Question: Will the Fee Schedules remain the “sole property” of the WCC, as contemplated by the RFP (V. Mandatory Provisions, D. Rights Reserved to the State, 5. Sole Property of the State)?
Answer: This will be considered as part of the vendor selection process and subsequent contract negotiations. The contract is not required to designate the Fee Schedules as sole property of the WCC.
13. Question: Will the WCC retain the “right to publish, distribute, or disseminate”, as contemplated by the RFP (V. Mandatory Provisions, D. Rights Reserved to the State, 5. Sole Property of the State)?
Answer: This will be considered as part of the vendor selection process and subsequent contract negotiations, but WCC anticipates the “right to publish, distribute, or disseminate”, certain aspects of the fee schedules such as the narratives.
14. Question: The RFP (V. Mandatory Provisions, D. Rights Reserved to the State, 5. Sole Property of the State) states that “Any product, whether acceptable or unacceptable, developed under a contract awarded as a result of this RFP shall be the sole property of the State, unless stated otherwise in this RFP or subsequent contract. The right to publish, distribute, or disseminate any and all information or reports, or part thereof, shall accrue to the State without recourse.” Will the Vendor retain any rights to the Fee Schedule? (In other words, is anything “stated otherwise in this RFP” or does the WCC anticipate the “subsequent contract” “stat[ing] otherwise”?)
Answer: WCC anticipates sole property language being included in contract negotiations, with WCC maintaining copyright of the fee schedule, while the vendor maintains copyright of the data.
15. Question: Will the WCC maintain the copyright to the Fee Schedules?
Answer: This will be considered as part of the vendor selection process and subsequent contract negotiations, but WCC anticipates maintaining copyright of the fee schedule, while the vendor maintains copyright of the data.
16. Question: Under the current contract, the rate charged for a copy of the fee schedule varies by type of user. For example, bill review companies pay based on the number of clients while other entities pay based on the number of “users”. Will this arrangement continue or will a single price be set for all access to the fee schedule?
Answer: This will be considered as part of the vendor selection process and subsequent contract negotiations.
17. Question: Under the current contract, pricing is on a per user basis but a user is not defined in the current contract or in the new RFP. How does the state define a “user” of the fee schedule for pricing purposes?
Answer: This will be considered as part of the vendor selection process and subsequent contract negotiations. WCC anticipates the user will likely be defined as anyone who purchases rights/ licensure to the fee schedule, including the data therewithin whether it be for themselves or someone within their organization.
Terri Miro
Administrative and Managed Care Program Manager
terri.miro@ct.gov
(860) 493-1500