Finding malfeasance, mismanagement, incompetence, or just plain fraud related to workers comp is pretty easy if you confine your search to Ohio. The latest comes from the Plain Dealer in a report on vocational rehab companies that have benefited enormously from their cozy relationships with managed care firms.
Reporter Bob Paynter’s article points out that costs for voc rehab have increased at twice the rate of inflation, with most of the dollars flowing to rehab companies that are tied to state-regulated MCOs. And we’re talking big bucks here – in 2002, over $55 million, with about one-third of that going to rehab companies from affiliated MCOs.
If they were doing great work, that would be fine. But indications are that their work is at best self-serving, and at worst a gaming of the system to drive dollars to the rehab companies with little concern for the injured worker. According to the article;
” The MCOs get bonus money from the state based on how quickly they close injured worker cases, Anderson said, not necessarily on whether the workers get services they need most.
As a result, he said, the goal of the affiliated rehab providers is to bill all the expensive services and then close the case as soon as possible.
“They’ve got billing down to a science, in terms of what gets them the most amount of money,” Anderson said. “The whole process is tainted.”
What does this mean for you?
Unintended consequences resulting from legislation/regulation developed by those who did not know any better…but should have.
