Workers comp bill moves ahead, increased use of workplace medical programs is missing

A workers compensation package is at the front end of a three-day race through the chambers of the Oklahoma Legislature. Senate Bill 878 
seems likely to pass, although volatility in the Republican ranks (inside and outside of the legislative bodies) has put some conservative proposals at risk.
With language that circulated beginning early this week, the bill is now being carefully studied by reporters and lobbyists – a daunting task in light of the more than 200 pages of new law it includes. 

While there is widespread agreement this measure — by state Rep. Dan Sullivan of Tulsa and state Sen. Anthony Sykes of Moore — is an important reform package, some business interests are frustrated. In interviews with CapitolBeatOK, sources said there were missed opportunities, in the final stages of crafting the measure, to lower system costs for businesses and better serve injured workers.

Certified Workplace Medical Plans (CWMPs) are already utilized by some companies in Oklahoma’s workers compensation system. However, hopes of the handful of state businesses providing CWMP in this market for their increased throughout the system have, this year at least, been dashed. 

At the end of a House Conference Committee hearing yesterday (Tuesday, May 17), S.B. 878 advanced on a 7-0 vote, with five members not voting. 

Supporting the conference report were state Republican Reps. Steve Martin of Bartlesville, Mark McCullough of Sapulpa, Lewis Moore of Arcadia, Dustin Roberts of Durant, Colby Schwartz of Yukon, Paul Wesselhoft of Oklahoma City and the chairman, Sue Tibbs of Tulsa. 

Not voting on the new version of the bill were Fred Jordan of Jenks, a Republican, and Democrats Richard Morrissette of Oklahoma City, Paul Roan of Tishimingo, Ben Sherrer of Pryor Creek and Cory Williams of Stillwater. 

Among many other provisions, the bill grants physicians input on development of Oklahoma Treatment Guidelines. This provision flows from the measure’s mandate that, for the first time in state history, physicians will be bound by Official Disability Guidelines (ODG). 

In discussion about the bill during the conference committee meeting, Rep. Sullivan said the rational for many changes is to try to bring down utilization of surgeries in Oklahoma. 

On this particular issue, there will be opportunities to have variance from ODGs when reasons are deemed “reasonable and necessary.” In a candid exchange with the committee, Rep. Sullivan conceded some participants in the system will quarrel with increased involvement of physicians in shaping those guidelines. Concerning greater reliance on guidelines, Sullivan reflected, “everybody likes guidelines — until you’re the patient.”

One individual involved in development of CWMP policies is Dan Simmons of CompChoice. In a commentary for The Oklahoman (March 11, 2011) he described a study by SGRisk that concluded use of workplace medical programs could bring 22 percent annual savings in workers’ comp costs. 

As he put it, “The CWMP managed-care model delivers these savings by providing protocol-driven oversight through the injured worker’s recovery process, ensuring the best possible medical treatment is available at a discounted rate and that injured workers returns to work as quickly as possible.” 

Proposals floated in recent months had pressed for expansion of the use of CWMP, and a required insurance premium reduction for participating companies.

After the House conference meeting yesterday, a knowledgeable source said he was not sure why CWMP improvements did not survive the drafting process. This source speculated that insurers “might not have wanted to be told what to, do i.e. the reduction in premiums.” Opposition to the CWMP enhancement might also have come from lawyers in the workers comp system, another observer told CapitolBeatOK.

The author, Rep. Sullivan, said in yesterday’s open hearing (another in the historic series of open conference committee sessions) that the ODG provisions were “my least favorite part of the bill.”