California is much better, Florida is doing great, heck, even Texas is really trying to fix its workers comp system. Among the larger states, that leaves NY as the leader in the “state that needs workers comp reform the most” contest.
And boy does it.
Manufacturers in NY rated workers comp as their “most onerous regulatory burden”, worse than taxes and unemployment insurance. 95% of respondents said WC in their state was much worse than in others, and 60% said it has gotten worse over the last few years.
But there appears to be hope. The Business Council is working with state GOP leaders and new Gov. Spitzer in an effort to address some of the more problematic issues. The Governor has made work comp reform one of his priorities, although it may not be at the top of the list.
Having recently completed audits of workers comp claims (focusing on medical management) in New York for two clients, here are the issues I see as most important.
1. Allow employers to direct injured workers to physicians with expertise in treating workers comp patients.
2. Require the workers comp board to consider evidence-based medical guidelines when evaluating treatment, and not just the treating physician’s or IME physician’s opinions.
3. Require payers to utilize evidence-based clinical guidelines in managing the medical component of work comp claims. And require those payers to share the guidelines with treating physicians.
4. Require payers to provide data to the state pertaining to medical treatment, including diagnoses, physician identifiers. procedures, costs, and outcomes. Require the state to provide access to these data in a format that enables all users to analyze the data to assess providers, treatments, and outcomes. Specifically publish data on variations in practice patterns.
5. Require payers to work together with providers and regulators to publish provider practice analysis results.
6. Adopt a mandatory generics law for drugs, similar to the one in Michigan.
If I had to settle for one of the above, I’d choose #5.
NY? What do you think about ILLLINOIS WC?
Joseph,
Is there any way I could recieve a copy of your two surveys on pharmacy management in workers comp?
You can e-mail me at Mompa_2000@yahoo.com.
Thanks.
Well I have been out of work since oct 2006 from occupational injuries. Everytime i need to see a doctor there is a average 2 month wait and the same goes for the work comp hearings. As of yet my work comp claim has not been opened and my disability benifits are almost expired. I Need surgery and I wont be able to get it till the comp is established and my case opened. But wait I was recently told that the insurance company can appeal leaving me to wait another 6 to 9 months. In a few weeks my disability runs out leaving me with nothing. All this time i spent waiting I could of had the surgery, recovered and been back to work which is all I want. Too bad too many other people are making money from my injury, so this will go on as long as the work comp system stays the same. I now feel very alone and me? danny13760@yahoo.comfrustrated with this whole process. Can anyone advise