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What's NewComp Changes Move UpCommittee approves plan for overhaul in workers' compensation 11:43 PM CDT on Wednesday, May 25, 2005 By KATHERINE YUNG / The Dallas Morning News Texas' system for treating injured workers moved a giant step closer to getting an overhaul after a House-Senate conference committee approved a massive revamp Wednesday. The bill represents the most sweeping changes to the state's workers' compensation system since 1989. The most significant changes include creating a managed-care network of medical providers and abolishing the state agency that regulates the system. Both houses must adopt the measure and Gov. Rick Perry must sign it before it can become law. "This agreement represents a major victory for everyone who has a stake in the workers' compensation system," Mr. Perry said. "It will give those hurt on the job the care they deserve at a price that employers can afford." Fixing Texas' troubled workers' compensation system was a top priority of the legislative session, but agreement came only after intervention by the governor's office. Even though the number of injured workers in Texas has been dropping, the state's workers' compensation system has been plagued by the overuse of medical care, difficulties in finding qualified doctors, soaring costs for businesses and other woes. Texas is the only state
where workers' compensation insurance is not mandatory for employers.
As a result, many have been exiting
the system, fed up with skyrocketing costs. And Texas ranks last among states when it comes to getting injured workers back to work, according to the Work Loss Data Institute. The bill was met Wednesday with enthusiastic support by business groups and the insurance industry. "We've been sorely in need of this reform for a long time," said Sam McMurry, workers' comp administrator for Lockheed Martin's aeronautics division in Texas. Workers' advocatesBut workers' advocates expressed muted support. "We have hope, but we also have a lot of concern," said Rick Levy, legal director for the Texas AFL-CIO. Some groups, including the Texas Medical Association, declined to comment because they had not seen details of the bill. The bill doesn't solve all of the system's problems. For example, it only slightly modifies the way medical disputes are handled. And it doesn't increase the maximum weekly income benefit by as much as some workers had hoped. But legislators are betting that the formation of a network of medical providers will go a long way toward solving many of the system's drawbacks. They hope a network will attract more high-quality doctors and other providers. Many had fled the system in 2003 because of reduced payments, increased paperwork and other bureaucratic hassles. Under a network, insurers would negotiate fees with medical
providers, potentially resulting in higher pay and less paperwork.
A network
system would also establish firm guidelines for treating injured
workers, which could help reduce the number of disputes over
medical care. Other statesTexas isn't the first state to embrace a network. Colorado and several other states are trying to reduce costs and improve the quality of care by mandating them. Participation in Texas' network will not be mandatory. A handful of studies have shown that networks significantly reduce medical costs, said Richard Victor, executive director of the Workers' Compensation Research Institute. But the effect on quality of care is less clear, he said. "Managed care in general health care has not been something that has been met with great satisfaction by most people," warned Mr. Levy of the AFL-CIO. Much of the network's effectiveness will depend on how it is set up and regulated, experts said. In addition to a network, legislators agreed to set up a disability management program, said Steve Nichols, manager of workers' compensation services at the Insurance Council of Texas. Under this provision, insurance carriers, employers and medical providers will work together to ensure that injured workers get the care they need so they can go back to work. Many large companies already have these kinds of programs. Other than the formation of a network, the bill's most significant change involves abolishing the Texas Workers' Compensation System and moving its duties to a newly created division of the Texas Department of Insurance. Legislators had adopted this approach to improve the efficiency and responsiveness of the workers' compensation system, which many injured workers have found to be confusing and complicated. This kind of setup is common in 31 other states, where workers' compensation is part of larger state agencies. Staff writer Christy Hoppe contributed to this story. |
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