Medical Providers Aren't to Blame for Rising Workers' Comp Premiums

Saturday, March 10, 2007 | 0

By Debbie Kobold

Montana workers' compensation insurers pay medical providers in this state far less than private health insurers, and in most cases, less than even what Medicare and Medicaid pay for the same services. Many people don't realize that medical providers in this state don't get paid what they normally would receive for providing the same services performed on patients not injured on the job.

In a Feb. 22 guest opinion in the Billings Gazette, Rep. Scott Mendenhall, R-Clancy, stated that Montana ranks "as the fifth-worst in the nation" regarding premiums charged to businesses. He alleges that this situation is due to higher medical costs. The medical providers in Montana are not at fault for higher workers' comp rates. It is the insurance companies themselves who have created this crisis by working solely to increase profits.

Don't penalize caregivers

We already have a system in place that dictates to medical providers what their services are worth, and it does not consider their costs of providing these services, much less the benefits they are providing to injured workers. Mendenhall's legislation will result in an inability for injured workers to find physicians willing to treat them. Don't penalize the providers who can actually return the injured claimants to the work force by legislating what their services are worth.

Rep. Mendenhall's second proposal was to "inactivate claims after a two-year statutory period." This is outrageous. First, workers' comp adjusters push for "conservative care" (i.e., medications, physical therapy, etc.) before approving invasive procedures such as surgery. Many injured workers do not even undergo surgery for years after their injury, and often that surgery will result in additional surgery down the road to remove hardware, scar tissue, etc. Insurance adjusters are not doctors with extensive training in these areas, yet they are telling doctors how and when to treat their patients.

Eliminating medical benefits after two years is also bad public policy because private health insurance does not cover conditions that are work-related.

Increased insurance profits

For the past 10 years, legislation has been enacted that has resulted in a reduction in benefits for injured workers, a reduction in compensation for the providers who treat them, higher premiums for employers - and increased profits for the insurance companies (which they are now allowed to invest in the stock market). The Gazette reported on Oct. 25, 2005, that "State Fund CEO Lanny Hubbard, already the highest-paid state employee, will receive a $41,000 payment in addition to his $179,000 annual salary." That article further pointed out that "five company vice presidents get an average of $16,000, while the average payment for nonexecutive employees is $4,200." Reduced payments to providers and increased rates to businesses fund those bonuses.

It is true that workers' comp premiums in Montana are killing and even closing businesses. It is also true that medical costs have risen. The truth that nobody seems to want to talk about is that the insurance companies are increasing profits on the backs of injured workers and their medical providers. Scott Mendenhall now wants to limit who can treat us and for how long we can be treated. Think about it and cross your fingers that you never suffer a work-related medical condition.

Debbie Kobold is a paralegal with a Billings law firm and works with workers' compensation law. This column first appeared as a guest editiorial in the Billings Gazette on March 1. The newspaper's Web site is http://www.billingsgazette.net.

----------------------------------------

The views and opinions expressed by the author are not necessarily those of workcompcentral.com, its editors or management.