Workers’ Comp Bills Seek to Improve Care, Reduce Costs

Friday, April 20, 2012

COLUMBUS, Ohio -- Three bills have been introduced in the Ohio Legislature that target Bureau of Workers' Compensation reform and are designed to help injured workers achieve better outcomes and get back to work more quickly. Bureau employees have spent the past year identifying areas for improvement, primarily related to improving declining return-to-work rates, officials report.

“Gov. John Kasich has asked us to find ways to make the system work better, and these reforms are reasonable steps to help address the most immediate problem of getting injured workers healthy and back to leading productive lives sooner,” said Steve Buehrer, bureau administrator/CEO. “The longer injured workers go without treatment and the longer they remain off work, the less likely it is they will ever achieve total recovery,”

Buehrer joins state Reps. Barbara Sears, R-64 Monclova Township; Craig Newbold, R-1 Columbiana; Al Landis, R-96 Dover; Mike Henne, R-36 Clayton; Jay Hottinger, R-71 Newark; Bob Hackett, R-84 London; and John Adams, R-78 Sidney, in announcing the reform legislation.

Over the last five years, the number of injured workers with lost-time claims who have returned to work has dropped from 75% to below 69%, Buehrer noted.

Prior to seeking legislative reform, BWC initiated a number of reforms that could be done within the authority of the bureau and its board of directors. These include pilot programs to better manage the claims process and more quickly identify candidates for vocational rehabilitation. The bureau also has enacted a drug formulary and pharmacy lock-in program to better manage prescriptions, and created a program that provides incentives for employers to focus on safety programs, transitional work and vocational rehabilitation programs for injured workers.

Specific elements of the legislative bills include:

• Ensuring care sought in the first 45 days following an injury is paid for regardless of whether the claim is eventually allowed or denied, encouraging injured workers to seek care -- and doctors to provide it -- without concern over the bill;
• Requiring managed care organizations to create provider networks focused on quality care and return-to-work, and requiring injured workers to use a network provider after 45 days;
• Encouraging workers to follow treatment protocol and move through the treatment process in a timely manner by tying certain benefits to their compliance with the treatment plan;
• Rewarding high-performing providers by easing payment processes and offering bonuses;
• Protecting injured workers by codifying BWC’s authority to immediately decertify providers who present a clear danger to public health and safety;
• Requiring all provider decertification appeals be made in the Franklin County Court of Common Pleas;
• Protecting the integrity of BWC fraud investigations by keeping investigation records confidential until the close of an investigation;
• Saving employers money by codifying their access to rating and discount programs that focus on safety and getting injured employees back to work sooner, including the Destination: Excellence risk management program and BWC’s new Wellness Grant Program;
• Providing greater flexibility for state universities by allowing them to participate in self insurance;
• Saving money for schools and local governments with minimal claims by allowing them to participate in the One Claim Program;
• Eliminating the additional premium assessment for older claims where the worker is permanently and totally disabled;
• Reducing bureaucracy by removing some requirements related to printed materials and certified mail.

SOURCE: Ohio Bureau of Workers' Compensation.

Published by The Business Journal, Youngstown, Ohio.