Workers Comp Group Divided On Need To Cap Medical Charges

Dec 19, 2014

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A commission studying ways to reduce workers compensation costs in New Hampshire released its final report Friday, but did not go so far as to recommend a cap how much health providers can charge for the care of injured workers.

Instead, in the 38-page report, a majority of commission members recommends the panel continue its work for another year.

The majority also endorsed creation of a database of workers compensation claims, as well as allowing employers and insurers to more closely manage pharmacy benefits to reduce the costs of prescription drugs, especially addictive painkillers. Both measures would require approval of lawmakers.

Three members voted against the final report, saying it is “contrary to the purpose of the commission.”

New Hampshire had the highest workers compensation costs in New England in 2012, and the ninth highest in the country. One reason is that New Hampshire is one of only a half-dozen states that does not limit what hospitals and physicians can charge for care in the workers compensation system.

In November, the state Department of Insurance reported that, on average, surgeons charge 156 percent more to operate on New Hampshire workers compensation patients, while radiology charges are 107 percent higher. Claims for an ice pack are more than 300 percent higher for injured workers than for non-workers compensation patients.

On average, surgeons charge 156 percent more to operate on New Hampshire workers compensation patients, while radiology charges are 107 percent higher. Claims for an ice pack are more than 300 percent higher for injured workers than for non-workers compensation patients.

  A statement by commissioner Peter McNamara, president of the NH Automobile Dealers Association, and signed by three other commission members said the state should adopt a medical fee schedule based on the state’s Comprehensive Health Care Information System, which collects group health payment data.

“This group schedule would be fair to medical providers and not difficult or expensive to implement,” the statement said. “If medical providers are accepting group health payments for non-work related injuries, what is the rationale for requiring workers compensation payers to pay upwards of 200 percent or 300 percent more for the same treatment?"

Insurance Commissioner Roger Sevigny, who chaired the 15-member commission, backed the final report, but said in a statement that he “agreed in principle” with the minority’s recommendation to adopt a fee schedule, saying it would help control costs.

“Work should begin immediately on the creation of a fee schedule that is fair and based on the real costs of health care in New Hampshire,” Sevigny said.

Gov. Maggie Hassan created the commission in September, citing the burden of workers compensation costs on New Hampshire businesses. In a statement, Hassan thanked the commission members for their work.

“We know that we must reduce workers’ compensation costs while ensuring that injured workers have access to high-quality care,” she said, “and I look forward to working with legislators from both parties on reforming our workers’ compensation system so that our businesses are able to re-invest these dollars in growing their companies, creating new jobs and keeping our economy moving in the right direction.”