CA 2012 Senate Insurance Committee Hearing On Workers Comp “Reform” SB 863; August 28, 2012
The RBRVS would give an opportunity for increased reimbursement, which would allow a greater percentage of primary care treating physicians into the system.
We are the regional society for occupational medicine physicians and a lot of our members work as primary treating physicians in the system. I’ll try to be brief.
There’s also a question with the specialists that there’s a fear that if the system will drive out the specialists. Concentra we also use specialists in our centers. We have working relations with them and so what would hurt the specialists would also hurt us.
Ten (10) years ago the Lewin Group quantified the gross under evaluation of primary care services within the system. That disparity exists today and represents real loss value, not just in... because OC [occupational] Med physicians are in short supply, but because a lot of the value that primary care can add simply can’t be delivered.
Existing law requires that medical provider networks to have sufficient physicians to treat injured workers so that would protect it. Diversion of workman compensation would be mandated to study access and make adjustments to the fee schedules needed to ensure access.
The... Just one example, maybe... quickly. A worker gets injured, works in the warehouse; may be capable of doing light desk work. That arrangement obviously keeps the worker engaged with their job connected to their workplace society, that they may recover more quickly, a lot of down stream and frustration and hostility and litigation could potentially be avoided.
SB863 provides four (4) years of transition to avoid shocking the system; so there will be adjustments but the system will be graded over time with the protections mentioned above and will avoid the tex... the mistakes that have occurred in Texas.
Physician to facilitate that arrangement talks to the patient, talks to the employer, goes back to the patient, goes back to the employer, back and forth again. Sometimes it’s a little tense but it can work if the physician can take the time and has the latitude to go ahead and make that series of phone calls.
I myself, have practiced in Texas and my personal experience the system’s working now, but the transition was too hard and too fast and was too difficult. So we, in this bill have addressed that, learning from their mistake.
Now there’s nothing in the current fee schedule that encourages a physician to do that. The fact is we... incentivise virtually nothing on the case management side, no open case management, no disability management.
The important to remember that over twenty five (25) states have adopted the RBRVS system and none have abandoned it, none have abandoned it once it was implemented. So this is our chance to help the injured workers of California, provide a better quality physician and provide better care.
Now granted, SB863 doesn’t redress all of that, but it does provide for a basis level of support for primary care services and a.. which we think that’s a step in the right direction. Thank you.
HENRY T. PEREA, COMMITTEE CHAIR:
Great, thank you. Last witness.
HENRY T. PEREA, COMMITTEE CHAIR:
DON SCHINSKE; WESTERN OCCUPATIONAL ENVIRONMENTAL MEDICAL ASSOCIATION (WOEMA):
Great, thank you very much. Any questions or comments for this panel? I see none, thank you very much. Now we will move on to the public comment section. I’d just like to remind the... get their position on the record. So if you could help us with that, you’re gonna want to say more but do your best to try to keep it at that. Thank... We’re not taking a vote today. This is only informational. This is... Please sir.
Don Chinskee on behalf of the western Occupational Environmental Medical Association.
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