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Workers' comp reforms slow going, officials say

Too early to tell if changes will reduce costs, bring doctors back

Dallas Business Journal - September 22, 2006
by Jennifer Gordon - Staff Writer

The state's workers' compensation system is slowly, but surely, recovering.

At least that's the consensus from workers' comp gurus from across the county who met in Dallas Sept. 13 to 15.

Last year Gov. Rick Perry signed into law sweeping changes to the workers' compensation system outlined in House Bill 7. The changes included limiting chiropractors' role in the system, mandating electronic billing, establishing managed care-type networks to reduce costs within the system, and implementing a variety of governmental shifts in Austin.

More than 100 people gathered at the third annual Texas Workers' Comp Forum in Dallas to hear about the new reforms and steps individual companies had taken to reduce claims.

"We've made significant progress," Norma Garcia, general counsel for the Texas Department of Insurance's Division of Workers' Comp, told the attendees. "We still have a long way to go. It hasn't been easy, but it's always been interesting."

Still being worked through are how to structure and design criteria for performance-based oversight and review under the new system. Division officials also are busy promulgating rules to flesh out new requirements and working with groups to certify health care networks mandated under the law.

The reforms, which will take effect over the coming months, were designed to decrease costs and bring doctors back into the system. "We're hoping to get doctors back with new improvements," Garcia said.

It's too early to tell if either has happened since the reforms were announced.

"Groundwork is laid for two things -- better treatment and savings," said Bill Hammond, president of the Texas Association of Business. "We need to move along rapidly and get more people in the system."

Networked approach

To date, there are four networks certified to treat workers in Collin, Dallas, Denton, Ellis, Kaufman, Rockwall and Tarrant counties. At this point, 153 of Texas' 254 counties are covered by at least one network. Another 20 groups have applied to be certified as workers' comp networks but have not received state approval yet.

Concentra Healthcare Network, based in Addison, and Texas Star Network/Concentra operate in all the Metroplex counties. Concentra is involved in multiple networks throughout the state.

Irvine, Calif.-based CorVel Healthcare Corp. and its CorCare network is certified to operate throughout most of the Metroplex except Ellis County.

American Airlines Inc. is using this network, Misty Jeffryes, worker's compensation claims manager for American Airlines, told the attendees at the worker's comp forum. The Fort Worth-based airline went live on the network on Sept. 1 and expects to save 10% once the network is fully implemented, Jeffryes said, adding that, "Everything has gone pretty well."

Dover, N.H.-based Liberty Mutual Managed Care Inc., which does business as Liberty Health Care Network, is certified to manage worker's cases in Collin, Dallas, Denton and Rockwall counties.The list of certified networks is available at www.tdi.state.tx.us/wc/wcnet.

 

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