Tony Fiore, Director

On Tuesday, April 17, several House members and the Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Stephen Buehrer held a press conference at the Statehouse to announce the introduction of three workers’ compensation reform bills (HB 516, HB 517, and HB 518). The legislators that took part in the press conference included State Representatives Barbara Sears (R-Monclova Twp.), Craig Newbold (R-Columbiana), Al Landis (R-Dover), Mike Henne (R-Clayton), Jay Hottinger (R- Newark), Bob Hackett (R-London) and John Adams (R-Sidney).

The first bill, HB 516, sponsored by Representatives Hottinger and Henne focuses on reducing bureaucracy and directing BWC to provide many of the incentive programs discussed in the January HRACO Newsletter article on workers’ compensation. One administrative provision allows BWC to publish its rules electronically rather than in paper form to reduce agency printing costs. While the biennial printed versions of the rules serve as good reference guides they often become outdated when statutory or administrative rules are amended throughout the year, thus online versions will serve a more accurate snapshot of compliance for human resource (HR) professionals.

Another section of the bill directs BWC to expand existing programs and make employer cost saving programs available that encourage workplace safety, drug-free workplaces, employee wellness programs, job development and claims management. For example, if you are a HR professional or benefits manager for a university hospital, HB 516 would allow your organization the ability to apply for self-insurance rather than pay premiums as a state-funded employer. In addition, the bill would permit cities, schools and other public taxing districts to participate in the One Claim Program. If an employer experiences a significant, unexpected claim, the One Claim Program provides a tiered discount of 20% in year 1, 15% in year 2, 10% in year 3, 4, and 5. Other sections of the bill would eliminate an automatic annual employer assessment for certain injuries prior to 1987 (called the Disabled Workers Relief Fund or DWRF I) since adequate reserves have been collected in the past to cover such claims and remove the requirement that employer objections to assessments be filed using certified mail.

The second bill, HB 517, sponsored by Representatives Sears and Newbold, is focused on achieving positive medical outcomes in order to return injured employees to work in a more timely manner. BWC Administrator Buehrer outlined the problem with the existing system by stating that 7 percent (or between 7,000 and 8,000) of injured workers do not return to work within 45 days from the date of injury. He further stated that the goal is to reverse the trend over the last 5 years where the return to work rate has gone from 75 percent to under 69 percent.

To address these trends, HB 517 requires more accountability from BWC, managed care organizations (MCOs), healthcare providers, the employer and the injured worker. For employers, the bill would require BWC to issue a report grading quality outcomes of MCOs and providers, including return-to-work rates. This information will give employers additional information that would be useful in selecting an MCO every two years.

For injured workers, the BWC report on quality outcomes will provide claimants with valuable information for selecting a provider that has a history of providing high-quality care in order to encourage timely recovery from injuries and earlier return to work. Another significant provision in HB 517 preserves an injured worker's ability to select any willing provider out of the 68,000 in Ohio within the first 45 days after an injury, but directs an injured worker to choose a provider within the existing MCO network of providers after the initial 45 day period. Administrator Buehrer stated that this is a fair requirement on the part of injured workers, especially when considering that some states require utilizing a network provider from the date of injury. The bill also requires injured workers to participate in their required medical treatment plans and vocational rehabilitation programs in order to maintain their full benefit eligibility. A claimant that refuses or unreasonably delays treatment without good cause will forfeit compensation and medical benefits during such time.

For providers, HB 517 prescribes a reduction of bureaucratic “red-tape”, allowing them to focus solely on providing high-quality care for Ohio’s injured workers. The bill provides presumptive authorization and prompt payment of medical care sought by injured workers within 45 days of the injury regardless of whether the claim is denied or allowed. This requires the provider to more accurately determine whether a claim should be considered a work related injury and filed with BWC, or a general health condition that should be claimed under the employees’ health insurance. If the claim is denied, BWC will seek reimbursement from the workers’ health insurance, and thus should not increase the employer’s cost of workers’ compensation.

The third bill, HB 518, sponsored by Representatives Sears and Landis, focuses on underperforming providers in Ohio’s workers’ compensation system. The bill codifies BWC’s ability to immediately decertify providers that present a danger to the health and safety of injured workers. In addition, the bill provides consistency in the decertification process by requiring all decertification appeals to be filed in the Franklin County Court of Common Pleas. Finally, HB 518 protects the integrity of BWC fraud investigations by ensuring evidence is not subject to civil discovery or public records requests until the investigation is complete.

Collectively, the three bills provide focus and attention on incentives for employers to provide safe work environments for employees, in order to prevent injuries from happening in the first place. Additionally, the bills require outcome related information be provided to both employers and injured workers, in order for them to make informed decisions regarding management of care when an injury does occur and selection of providers focused on quality care and returning the employee to work as early and safely as possible.

HR professionals and the employers that fully fund Ohio’s workers’ compensation system are intently focused on the health and well-being of their workforce. Requiring that data be made available to both employers and injured workers deciding on the right MCO to manage claims, and the best provider to offer quality care, is critical to ensuring the system will work for both primary stakeholder groups. Such directives ensure that employers don’t pay more than necessary for workers’ compensation insurance coverage and injured workers’ don’t get lost in the system.

While further improvements to the workers’ compensation system could be made, Ohio Governor John Kasich was quoted by The Columbus Dispatch saying, "It's not going to happen until the unions come to the table and want to participate." BWC Administrator Buehrer stated during the press conference that he has invited groups like the Ohio AFL-CIO to the table to discuss reforms to the system, but that those groups have thus far opted not to participate in the discussions. The Ohio AFL-CIO immediately came out in opposition to the three workers' compensations reform bills without commenting on their specific concerns over the proposed legislation or suggesting alternatives for providing more favorable outcomes regarding quality medical care and faster return to work for injured workers.

At the conclusion of the April 17 press conference, Chairman of the House Insurance Committee, Representative Jay Hottinger, stated that the Insurance Committee and its Subcommittee on Workers’ Compensation will hold hearings throughout April with the goal of passing the legislation out of the House in early May.