Oakland, CA – The Commission on Health and Safety and Workers’ Compensation (CHSWC) has released its twentieth Annual Report for 2014. The 2014 Annual Report presents information about the health and safety and workers’ compensation systems in California and makes recommendations to improve their operations.
The 2014 Annual Report includes CHSWC’s recommendations for legislative and administrative changes for the benefit of California’s workers and employers:
Re-examine the workers’ compensation system in light of the passage of Senate Bill (SB) 863, especially in the following areas:
- Permanent disability compensation
- Medical care quality, accessibility, timeliness and cost
- Timeliness and cost of dispute resolution
Monitor the utilization of the Return-To-Work Supplement Program benefit over two to three years to determine appropriate return-to-work supplement levels once the regulations are finalized.
Relating to medical care and SB 863:
- Evaluate the impact of the medical care reform provisions in the following areas: medical necessity determinations; medical provider networks; appropriate fees for medical and other services; medical evaluations; and timely payment for medical and other services.
- Evaluate the impact of the new provisions on cost, quality and access of injured workers to appropriate and timely medical care, and identify issues and make recommendations for addressing areas of potential concern.
- Evaluate reports and forms required by the Division of Workers’ Compensation (DWC) as part of managing the injured worker’s treatment.
- Consider implementing an Office of Workers’ Compensation Program (OWCP)-based fee schedule at least with respect to skilled home health services that would not otherwise be covered under the In-Home Support Services Program.
Relating to fraud:
- Continue to research ways to uncover the underground economy and enforce compliance with workers’ compensation and health and safety laws.
- Relating to payroll reporting by employers:
- Focus more Fraud Assessment Commission (FAC) funding on premium fraud enforcement.
- Develop a more systematic approach to detecting premium fraud.
- Continue examination of data-quality problems and improved reporting of employers’ coverage for workers’ compensation.
- Change the definition of first aid for purposes of workers’ compensation reporting to align with the definition used for Cal/OSHA purposes.
Continue to support the predictability, transparency, incentives and Department of Insurance (CDI) oversight of the workers’ compensation system, as suggested in a CHSWC study which examined the reliability of projecting claim costs.
Relating to developing an overall culture of safety to prevent workplace injuries:
- Continue support by labor and employers and the health and safety and workers’ compensation community for the CHSWC statewide Worker Occupational Safety and Health Training and Education Program (WOSHTEP).
- Continue to support training and outreach targeted at implementing an Injury and Illness Prevention Plan (IIPP).
- Recommend that the Insurance Commissioner consider lowering the experience rating threshold, in light of findings from a CHSWC study.
Relating to integrated medical care:
- Disseminate results of the evaluation of issues relating to implementation of integration of a medical treatment and insurance product
- Evaluate the impact of Medicare’s secondary payer rights on claim settlement and examine alternative ways to coordinate benefits between the two systems.
- Provide resources on integrated care for unions and employers interested in carve-out programs.
CHSWC, created by the workers’ compensation reform legislation of 1993, is charged with examining the health and safety and workers’ compensation systems in California and recommending administrative or legislative modifications to improve their operations.
Information may also be obtained by writing to CHSWC at 1515 Clay Street, 17th Floor, Oakland, California, 94612; by calling (510) 622-3959; by faxing a request to (510) 622-3265; or by email to email@example.com.
Source: CA CHSWC