Delaware: Legislation puts onus on carriers to ensure employers comply
H.B. 175 implements reforms developed by a special panel established to address the state's double-digit rate hikes in the last couple of years. The legislation will allow the Workers Compensation Task Force to continue to assess the impact of the reforms and make additional recommendations.
"Within 14 days of the issuance of an Agreement As To Compensation to an employee for any period of disability, the employer shall provide to the health care provider/physician most responsible for the treatment of the employee's work-related injury and to the employer's insurance carrier, if applicable, a report of the modified duty jobs which may be available to the employee," the legislation states. "The insurance carrier for an insured employer shall send to such employer the aforementioned report for completion, and shall be independently responsible for providing a completed report of modified duty jobs to the health care provider/physician."
The idea is to expedite return to work for employees, "which impacts the length of time they receive workers' compensation," according to a legislative summary.
The legislation also would reform the system used to scrutinize industrywide rate requests submitted by the workers' comp insurance industry. It would create an advocate in the process for businesses and establish a process "where that rate advocate can gather the information necessary to advocate for businesses and effectively present their arguments with respect to rates to the hearing officer making recommendations to the Department of Insurance," the summary says.
- Expand the responsibilities and resources of the Data Collection Committee, which is overseen by the Department of Insurance. The committee would be given "more frequent updates on medical cost drivers" and would be allowed to review "company-specific medical cost information and direct examination of companies that do not appear to be exercising sufficient oversight over medical costs."
- Implement changes to the existing medical cost control provisions, including a two-year inflation freeze on fees that would have been entitled to an annual inflation increase, a decrease in the annual inflation amount for hospitals treating workers' comp patients, and expanding the current medical fee schedule to include many additional procedures. It also provides new cost control measures for pharmaceuticals, drug testing, and anesthesia.
- Create a statute of limitations for parties wishing to appeal a utilization review decision.
- Implement several changes to the workplace safety credit program. It requires the program to be more rigorous about inquiring into past injuries in a workplace before awarding the credit, allows carriers safety inspections which are "at least as rigorous as those performed by the Department of Insurance to substitute for the Department's inspections," and requires that companies be compliant with their back-to-work responsibilities for injured workers before being eligible for the credit.
By Nancy Grover
Read more at the WorkersComp Forum homepage.
August 5, 2013
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