THE VALUED VOICE

Vol. 65, Issue 28
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Thursday, July 15, 2021

   

Management (Again) Wants Government Price Setting for Worker’s Comp

Also wants restrictions on injured workers’ access to care

The Worker’s Compensation Advisory Council (WCAC) members met and exchanged proposals this week, kicking off the negotiation between WCAC’s five voting members representing labor (Labor) and the five voting members representing management (Management) that is expected to result in what is often called the “agreed upon bill.” After introduction, the agreed upon bill is considered in the Legislature by the assigned Senate and Assembly committees. According to the Wisconsin Department of Workforce Development (DWD) website, the Legislature usually accepts the WCAC’s recommendations and forwards the bill to the governor, who signs the bill into law. A WCAC agreed upon bill, however, has not been approved by the Legislature and signed into law since 2016, due in large part to the controversial ideas the WCAC includes in the agreed upon bill. 

Despite the fact that premiums for worker’s compensation insurance continue plummeting in Wisconsin, Management once again included in its proposals for 2021 a medical fee schedule for hospitals. Management’s proposals also would require DWD to certify dispute resolution databases based on the average fees paid to health care providers. This would, in effect, establish a fee schedule and significantly limit reimbursement amounts for care provided by physicians, physical therapists, chiropractors and other health care practitioners. 

In addition, the Management proposal calls for employer-directed care for the injured worker’s first 90 days of treatment, except for care provided in the emergency department. To direct care, the proposal explains that the employer would specify a list of at least three physicians who are geographically accessible, plus three other health care providers. The proposal also would establish treatment guidelines that health care practitioners would be required to follow unless the insurer approves the practitioner’s recommended care in advance.  

Labor did not propose a medical fee schedule or restricted access to care, instead focusing its proposals on increasing disability and death benefits for injured workers, providing education and health benefits for the injured worker and his or her dependents and encouraging employer compliance with safety regulations, among other provisions. 

WHA President and CEO Eric Borgerding criticized Management’s proposals, saying, “It’s disappointing that management representatives would propose, again, 1970s-style government rate setting for worker’s compensation rather than encourage insurers to negotiate price and payment terms with health care providers, as the insurers do for group health and increasingly even government programs.” Borgerding also noted, “In late May, the Wisconsin Compensation Ratings Bureau recommended a 5.44% reduction in worker’s compensation insurance premium rates beginning October 1. That would be the sixth consecutive year with reduced rates. And, again, data show Wisconsin workers receive exceptional health care with outcomes that are the best or among the best in the country. Government setting prices, coupled with the workplace deciding where people injured at that workplace can get care, doesn’t make sense.”
 

This story originally appeared in the July 15, 2021 edition of WHA Newsletter

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Thursday, July 15, 2021

Management (Again) Wants Government Price Setting for Worker’s Comp

Also wants restrictions on injured workers’ access to care

The Worker’s Compensation Advisory Council (WCAC) members met and exchanged proposals this week, kicking off the negotiation between WCAC’s five voting members representing labor (Labor) and the five voting members representing management (Management) that is expected to result in what is often called the “agreed upon bill.” After introduction, the agreed upon bill is considered in the Legislature by the assigned Senate and Assembly committees. According to the Wisconsin Department of Workforce Development (DWD) website, the Legislature usually accepts the WCAC’s recommendations and forwards the bill to the governor, who signs the bill into law. A WCAC agreed upon bill, however, has not been approved by the Legislature and signed into law since 2016, due in large part to the controversial ideas the WCAC includes in the agreed upon bill. 

Despite the fact that premiums for worker’s compensation insurance continue plummeting in Wisconsin, Management once again included in its proposals for 2021 a medical fee schedule for hospitals. Management’s proposals also would require DWD to certify dispute resolution databases based on the average fees paid to health care providers. This would, in effect, establish a fee schedule and significantly limit reimbursement amounts for care provided by physicians, physical therapists, chiropractors and other health care practitioners. 

In addition, the Management proposal calls for employer-directed care for the injured worker’s first 90 days of treatment, except for care provided in the emergency department. To direct care, the proposal explains that the employer would specify a list of at least three physicians who are geographically accessible, plus three other health care providers. The proposal also would establish treatment guidelines that health care practitioners would be required to follow unless the insurer approves the practitioner’s recommended care in advance.  

Labor did not propose a medical fee schedule or restricted access to care, instead focusing its proposals on increasing disability and death benefits for injured workers, providing education and health benefits for the injured worker and his or her dependents and encouraging employer compliance with safety regulations, among other provisions. 

WHA President and CEO Eric Borgerding criticized Management’s proposals, saying, “It’s disappointing that management representatives would propose, again, 1970s-style government rate setting for worker’s compensation rather than encourage insurers to negotiate price and payment terms with health care providers, as the insurers do for group health and increasingly even government programs.” Borgerding also noted, “In late May, the Wisconsin Compensation Ratings Bureau recommended a 5.44% reduction in worker’s compensation insurance premium rates beginning October 1. That would be the sixth consecutive year with reduced rates. And, again, data show Wisconsin workers receive exceptional health care with outcomes that are the best or among the best in the country. Government setting prices, coupled with the workplace deciding where people injured at that workplace can get care, doesn’t make sense.”
 

This story originally appeared in the July 15, 2021 edition of WHA Newsletter