The Effect of the Affordable Care Act on Workers Compensation

Thursday, June 20, 2013 | 0

<i>Editor’s Note: The Workers' Compensation Institute's 68th annual Workers’ Compensation Educational Conference (WCEC) will be held Aug. 18-21 at the Orlando World Center Marriott. This article is part of a series highlighting some of the upcoming sessions.</i>

Now that the Affordable Care Act (ACA) has been signed into law by the president, declared constitutional by the U.S. Supreme Court, and rules are being developed, the realities of the law are being analyzed in detail by the American public. This includes the workers’ compensation industry, where health care remains an extremely significant component in overall benefits provided.

Concerns are being expressed by all segments of the industry, including injured workers, medical care providers, hospitals, employers, insurance companies and regulators. Because of the unknown—and realizing the potential adverse consequences of this most dramatic change in health care in decades in the United States—the Workers’ Compensation Institute has established as one of the central themes in this year’s annual Workers’ Compensation Educational Conference a review of this new law, its expected consequences on the workers’ compensation industry as a whole, and in particular, specific employer groups.

This comprehensive two-day study begins on Tuesday, August 20, in the annual Centers for Excellence breakout with a comprehensive review of the Act, how it affects all stakeholders in the health care system, and changes to be expected. This non-partisan, “tell it like it is” presentation appropriately labeled “The ACA-101” is sponsored by the American Health Lawyers Association in Washington, D.C., the conference’s newest partner. Presented by health care experts from throughout the country, this initial breakout is intended to give attendees a basic understanding of the far-reaching effects of the new law without focusing on any particular segment of the health care industry. Speakers are Barry Alexander of Nelson Mullins Riley & Scarborough, LLP in Raleigh, N.C.; Jennifer A. Kraft of Seyfarth Shaw, LLP in Chicago; and Arthur N. Lerner of 
Crowell & Moring LLP in Washington, D.C. 

After participants gain this basic understanding of the law, the next segment will relate to how this new law affects workers’ compensation specifically. This presentation will be made by two individuals who have devoted their professional careers to workers’ compensation, who understand the nuances of the system, and through this knowledge can reasonably predict the new law’s impact, good or bad, on workers’ compensation.

Judge David Torrey is a workers’ compensation judge in the state of Pennsylvania and President of the National Workers’ Compensation Judiciary, positions that put him squarely “within the know” of the uniqueness of workers’ compensation and the importance of medical care to the success of a viable workers’ compensation system.

Dr. Dean Hashimoto brings academia and practical experience on this issue to the conference. He is a professor at the Boston College University College of Law and also a licensed physician. Dr. Hashimoto’s unique qualifications include not only being a teaching attorney but also a medical doctor currently acting as Chief of Occupational and Environmental Medicine, Partners Healthcare System, that provides clinical services to 60,000 employees at eight hospitals and the administration of a centralized self-insured workers’ compensation claims system.

On Wednesday, August 21, Dr. Sanford Silverman, a Board Certified Pain Medicine Physician located in Pompano Beach, Fla., will moderate a panel on “Drug Repackaging and Physician Dispensed Mediation—A Growing Dilemma That Needs Resolution.” Panel members include Gary Cannon, Executive Director, South Carolina Workers’ Compensation Commission in Columbia, S.C.; Rod Bordelon, Commissioner, Texas Division of Workers’ Compensation in Austin, Texas; Lori Lovgren, Division Executive-State Relations, NCCI, Boca Raton, Fla.; and Gary Newcomer, M.D., First Care of Gainesville, Gainesville, Fla.

Dr. Silverman also will moderate a second discussion that day, “Emerging (Disturbing?) Trends in the Adoption of Treatment Guidelines.” Panel members are Phil Denniston, President, Work Loss Data Institute, Encinitas, Calif., and Ken Eichler, Director of Government Affairs, Reed Group, New York, N.Y.

The final session is “The Use and Abuse of Narcotics in the Treatment of Pain in the Workers’ Compensation System” moderated by Jay Kruefer, EVP of PMSI in Tampa. Speakers include Maria Sciame, VP Clinical Services, PMSI; Jill Rosenthal, M.D., Medical Director, Zenith Insurance Co., Sarasota, Fla.; Julie Fortune, Chief Claims Officer, Arrowpoint Capital,  Charlotte, N.C.; Suzanne Novak, President, Austin Outcomes Research, Inc., Austin, Texas.

The conference goes one step further and presents separate breakout sessions on the effect of the new health care law on particular employment groups within the workers’ compensation industry. Sponsored by the American Staffing Association (ASA), the National Association of Professional Employer Organizations (NAPEO), and the Florida Association of Professional Employer Organizations (FAPEO), discussions will take place and breakouts presented on how the new law will affect the temporary staffing and PEO industries.

Special presentations will also be made to the attendees of the College for Workers’ Compensation Judiciary, held in conjunction with the annual conference. This college is the only college in the United States specifically designed for workers’ compensation judges, and is attended by representatives from throughout the nation. Knowledge of the impact of the ACA on workers’ compensation adjudicators is essential for these decision makers when it comes to resolving disputes between the parties in workers’ compensation litigation.

Finally, attendance at these breakouts will be part of the recommended track for state regulators attending the conference sponsored by the Southern Association of Workers’ Compensation Administrators (SAWCA). There is no question that this new law will impact the future of health care in workers’ compensation (either directly or indirectly) and knowledge by regulators of this new Act is of paramount importance.