CA Insurance Commissioner – 27 Recommendations For Cutting Comp Costs
CA Insurance Commissioner issues recommendations to cut WC costs. After rejecting any increase in the pure premium rates for California this week, Commissioner Steve Poizner issued a proclamation citing 27 ways to cut Workers Comp Costs in CA.
A summary of those recommendations is:
All insurers should implement pharmacy networks with or without regulations based upon the example set by Safeway and the fact that the provisions of Labor Code Section 4600.2 do not require regulations as a prerequisite.
- Regulations should be implemented regarding physician dispensing of pharmaceuticals. Legislation may be necessary to deal with this.
Require the prescribing and/or dispensing of generic drug equivalents.
- Utilization Review needs some utilization review of itself. If a majority of medical requests are going to utilization review and are approved, it is not effective. Utilization review, as it was intended for health care, was for the outlier circumstance.
- Require billing and payment at the fee schedule.
- DWC should update the fee schedule immediately and continue to do it as an ongoing process.
- Regulations for electronic billing and a standard medical bill form need to be implemented.
These recommendations seem to center around the subjects of pharmaceuticals, utilization review, and billing practices.
Commissioner Poizner also announced the creation of a Workers’ Compensation Costs Advisory Group. This group, comprised of a cross-section of all participants, will meet on an ongoing basis. This will accomplish the purpose, similar to the investigatory hearing, of informing the commissioner and CDI staff regarding the key cost drivers in the system and make ongoing recommendations to deal with them.
California is usually at the forefront of Workers Compensation. These developments could be coming soon to your state. Check with your state’s office of the insurance commissioner for updates.
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