Fictional television meteorologist Phil Connors, played by Bill Murray in the movie “Groundhog Day,” found himself marooned in Punxsutawney, PA, forced to relive February 2 an untold number of times. Cynical and arrogant, Connors’s escape from the time loop happens only after he finally rejects the belief that he is superior to the “hicks” of rural Pennsylvania and realizes that life is best experienced in finding joy in self-improvement and doing good deeds.
It’s a lesson the state’s largest business lobby, Wisconsin Manufacturers & Commerce, has not yet embraced – at least when it comes to the state’s Worker’s Compensation (WC) system.
This week the Worker’s Compensation Advisory Council (WCAC), whose voting members come from the state’s Management and Labor entities, met in Madison to exchange proposals to be bargained on in pursuit of this legislative session’s “agreed-to” bill. Once unanimously agreed to, the bill is then presented to the state legislature as the recommendation for updating the state’s WC-related laws and regulations. The Wisconsin Medical Society (Society) is one of four health care liaisons to the WCAC, but does not have a vote on any final product.
Despite a recent recommendation that WC insurance premiums for businesses be reduced for a sixth consecutive year (see the May 27, 2021 Medigram) and hearing from a national worker’s comp think tank about Wisconsin’s excellent record in providing injured workers with effective and cost-efficient care (see the June 10, 2021 Medigram), the WCAC’s Management members have once again recommended major changes in a package that targets Wisconsin health care:
- Instruct the state’s Department of Workforce Development to create a medical fee schedule for hospital charges that would “strive to keep costs below the national average,” with the potential for different fee schedules in different parts of the state.
- Alter “black box” databases used to determine payments in WC fee disputes from charge-based databases to payment-based databases.
- Allow employers to direct where injured employees receive their care for the first 90 days (emergency care excepted), rather than the current system where injured employees can choose where to get their care.
- Require health care entities to bill, receive payments and transmit electronic records electronically.
- Transform treatment guidelines that are currently used during treatment dispute cases into treatment parameters absent pre-authorization from insurers.
You can see the outline of Management’s opening bargaining proposal here. Past “agreed-to” bills containing artificial health care fee schedules have historically fared poorly in the state legislature, failing to pass due to intense opposition from the Society as well as hospital, chiropractic and physical therapy entities.
Labor submitted its own comprehensive list as an opening offer, which you can read here. Among Labor’s proposal are items related to COVID-19 causation presumptions for certain occupations and a comprehensive recommendation on opioid use and treatment for injured workers who may show signs of addiction.
It’s unclear how many days Phil Connors relived February 2 – the movie shows 34 of those repeats but implies years of marmot-dominated purgatory. WMC’s continued push for failed ideas may be rivaling the length of Connors’ ordeal, but the Society will continue to educate legislators about the tremendous value Wisconsin health care brings to the nation’s model WC system until WMC moves on to its metaphorical February 3.
Meanwhile, the WCAC is next scheduled to meet on August 24. Contact Society Chief Policy and Advocacy Officer Mark Grapentine, JD for additional information.
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