Is There an Acceptable Path to Reforming the IWCC?

Monday, September 20, 2010 | 0

By Eugene Keefe
Keefe, Campbell & Associates
 
As we approach the coming elections, we are advising business representatives there may be reform afoot in the workers’ compensation system in this state. Last week, we met with a plaintiff/petitioner attorney; two noted surgeons and also discussed these issues with a number of veteran arbitrators.

We are generally certain the plaintiff/petitioner’s bar is completely reluctant to identify any acceptable area on which they are willing to accept any modification of the Workers' Compensation Act or rules. We feel this group is expected to fight any change or institutional reform with whatever muscle and political power they may be able to bring to the table. Not that they ever like to listen to this side of the political matrix, our message to them is to understand there is an inevitability to change. They might be better to find/source a few things they can accept to provide savings rather than dig in and fight and possibly be left on the sidelines.

From the medical perspective, we are advised by numerous national clients that Illinois has the highest reimbursement rates for medical care in the workers’ compensation arena in the United States. Our medical fee schedule has many gaps, the biggest and most glaring of which is the lack of coverage of surgical implants which a powerful lobby was able to keep out of coverage of the Illinois Medical Fee Schedule. There is also literally no pharmaceutical fee schedule which might rein in the fastest rising cost in workers’ compensation. We are also seeing the comical and heinous practice of “repackaging” and repricing of bona fide drugs starting to occur across the state. We truly feel this concept should be made illegal, as it is in some states.

Understanding our medical fee schedule was “lifted” from Wisconsin; we wonder why it may work there and stink here? Did those sneaky cheese-folks leave something out in the translation when they sent it south?

On another medical issue, as we told you last week, in our view, the forces of Illinois labor did not follow its promise to implement utilization review when it was enacted in 2005. This means medical utilization in Illinois remains among the highest of our nation’s workers’ compensation systems. Again, it is fascinating to see the Plaintiff/Petitioner bar join with some treating docs to insure what is arguably overtreatment will continue. This is clearly an area that would be wildly easy to reform. We wonder if some of the obvious overtreaters should be red-listed from participating in the workers’ comp arena as they are in some states.

The distinguished doctors we have talked to unite to advise of their common goal to keep high reimbursement levels in the Illinois workers’ compensation arena. They urge us to understand that approach is critical to their income. They all make a common refrain—“we treat group healthcare patients at a break-even level but make money on the workers’ compensation patients.” The unanimity of this argument makes us wonder how doctors in other states scrape by with more reasonable reimbursement amounts in workers’ compensation. We assure our readers we do not want to see workers’ comp treatment mills in Illinois.

We also want our readers to understand there is a common refrain from every defense client of our firm—Illinois workers’ compensation costs too much. They uniformly tell us Illinois stands out among other states on just about every level of benefit—medical, lost time and permanency. We have been advised high and ever-increasing workers’ comp costs are not a good thing for businesses in our state. Please never forget the lesson provided by long-time Illinois industrial giant Archer Daniels Midland when they wanted to build more ethanol plants. The last place they looked to build was in their home state—one reason was their experience with workers’ compensation. You can’t hide the bottom line impact, folks.

When we talk or write about WC reform, what we get from our peers in the legal and medical industry is a similar refrain—SSSSsssshh! Keep it quiet! If we don’t talk about it, maybe it will go away. Well, folks, we would rather not keep things a secret, as we have been told to do for years. We don’t think secrets do much for Illinois business. If you want to do things in secret, go for it but we would rather put things out in the open and see what the collective genius of the component members of the workers’ compensation forces in this state can bring to the plate.

So we ask all of you—if you were in charge, what would you change? Understanding we want to provide fair benefits to Illinois’ injured workers with real and disabling injuries but not provide a “reward” that encourages over-reaching and fraud by workers, what should Illinois do?

Please remember Keefe, Campbell & Associates is one of the many sponsors and inviting everyone to the Illinois State Chamber of Commerce Annual Workers’ Compensation Conference 2010 on Oct. 28, 2010 at the Chicago Marriott Oak Brook, Oak Brook, Ill. For questions or to register, contact Julie Brennan, Director of Customer Service, at jbrennan@ilchamber.org or call 217-522-5512 Ext. 226. We promise it will be a barn-burner as it will be held about ten days prior to the state-wide election.

Eugene Keefe is a founder and partner with Keefe, Campbell & Associates, a Chicago workers' compensation defense law firm. This column was reprinted with his permission from the firm's client newsletter.