Short Title: An Act amending the act of June 2, 1915
(P.L.736, No.338), known as the Workers' Compensation Act, in liability and
compensation, further providing for schedule of compensation.
Prime Sponsor: Representative
HICKERNELL
Last Action: Referred to LABOR AND
INDUSTRY, Feb. 12, 2015 [House]
Printer's No.: 512*
MEMORANDUM
Posted: January
14, 2015 02:33 PM
From: Representative
David Hickernell
To: All House
members
Subject: Workers'
Compensation Act Amendment
In the near future I plan to introduce legislation that
would amend the Pennsylvania Workers' Compensation Act to provide employers a
managed care option for their insurance plans.
Working in Pennsylvania has never been safer as
industries have evolved and employers continue to emphasize and invest in
workplace safety and employee health.
This progress has naturally led to fewer workers’ compensation (WC)
claims; yet the average cost of individual claims is increasing beyond the rate
of inflation due mainly to rising medical costs.
WC bills in the mid-1990s sought to help control excessive
medical costs by, among other reforms, providing greater managed care options
for employers. Reforms included
extending from 30 to 90 days the period following a workplace injury in which
the employee must seek treatment through a panel of providers if one is
designated by the employer and also providing for a healthcare network option
for WC known as Coordinated Care Organizations (CCO). While many states allow employers to
completely control provider choice or have no time limit on panels, these
managed care reforms in the mid-1990s were viewed as positive, albeit modest,
steps in the right direction.
Unfortunately, CCOs have never been implemented as
intended because they are subject to the same 90-day limit that governs
provider panels, so employers have always preferred to simply establish a
panel. This flaw in the statute has
prevented the WC system in Pennsylvania from utilizing a proven medical cost
containment strategy that is a standard feature in practically all other forms
of group health. Healthcare networks
help ensure acceptable standards of provider quality and integrity and allow
for more effective coordination among health professionals, which helps
eliminate unnecessary services, excessive or duplicative treatment and overutilization
of medication.
The managed care approach to healthcare has benefitted
stakeholders in all types of group health plans and for WC in many other states
and would benefit the WC system in Pennsylvania. My legislation accomplishes this by simply
providing that employers may choose to utilize a CCO through which a claimant
would receive treatment throughout the claim.
Though this reform falls short of the stronger direction of care options
afforded to employers in many other states, it is a reasonable amendment that
will improve the system, help address overly and unnecessarily excessive claims
and maintains a claimant’s ability to make his or her own healthcare decisions.
Previous Cosponsors:
HICKERNELL , BAKER , CUTLER , EVERETT , GINGRICH , GRELL , GROVE, C.
HARRIS , KAUFFMAN , MENTZER, METCALFE , MILLARD , PICKETT , SAYLOR , DUNBAR,
McGINNIS, JAMES and MURT
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