Governor Gray Davis signed the workers' comp reform legislative

[radwriter0555]

package including major bills SB 228 and AB 227 into law this afternoon. The law is expected, by California Department of Insurance estimates, to generate an ongoing annual savings of over $4 billion.



The law among other things, caps chiropractic and physical therapy visits at 24, sets a pharmaceutical fee schedule based on 100 percent of the Medi-Cal fee and establishes medical treatment guidelines. The impact on pure premium rates is still being worked out as the Commmissioner looks for more savings in the area of medical utilization guidelines and anti-fraud efforts. The Commissioner is hoping for a four percent rollback in workers' comp insurance rates in January. The law will take effect on January 1,2004.

[mitchtv]

1. too little, too late

.

[Semi_subversive]

2. This is only just the beginning

Trust me. My boss, Commissioner Garamendi, is a man on a mission.

[nothingshocksmeanymore]

6. Your boss needs to find out why only ONE carrier has been prosecuted

in the state for fraud when fraud on the part of carriers happens regularly.

Your boss also needs to read a series of articles covered in the Santa Rosa Press Democrat (her first name was Pat, can't recall her last name) a few years back (1996) covering the faulty fraud statistics used to pass the reforms in 1989 and 1993.(California Workers compenstion institute claimed it was 50%..actual claims onc carriers were MANDATED BY LAW to report it amounted to less than 1%)

Your boss needs to find out why carriers balk at delivering future medical care benefits LONG after applicants have had their day in court.

Your boss needs to look at the number of carriers that have been fined by OBEY for not obeying the labor code and to notice the ;altry effort they have made to comply with the labor code.

Your boss needs to ask what the carriers did with the 500 million dollar windfall profit they made off the reforms passed in 89 and 93 and why this never materialized to the net savings it SHOULD have accomplished for businesses..

Your boss needs to quit listening to Steve Peace who claims that deregualtion WORKED in the comp industry when in effect all it accomplished was the same thing it accomplished in the energy market...the option for LARGE businesses to PULL out and pass on the expense to small businesses by draining the financial pool reserves.

Your boss needs to conduct a study of the amount of money carriers pay their OWN attorneys (given applicants attorneys are limited to 12-15%).

YOur boss needs to look at the number of penalties and interest payments carriers make simply because they do not follow the law..thereby increasing their own costs by being scofflaws.

[salin]

3. so I wrench my back due to required heavy lifting and the

physical therapy visits are capped? The treatment guidelines tell my doctor how I can be treated rather than the doctor making the determination based on my needs? This is a good thing?

Sounds like the insurance companies just got more revenue - because you know the insurance rates won't drop.

[nothingshocksmeanymore]

7. Cookbook medicine...they don't want to pay penalties for denying prompt

and necessary care so they establish a guideline of what is reasonable based on other states with much more restrictive comp laws.

The guidelines were based on studies provided by the Rand Institute..you know..the company that brought you the Viet Nam war?

[salin]

9. would he have signed this without the intense pressure due to the recall?

would it have been more iffy? Did the recall itself seal the deal? Or would he have caved on it anyway? (Still no on recall... but not always a huge fan).

[nothingshocksmeanymore]

10. He has been being pressured to hand off more to carriers for the last

four years and always heldthem off.

A big (typical for Republicans) dealbreaker from the 89 reforms was that permanent disability benefits were to have gone up (California PD benefits rank low compared to other states)

The carriers back then said "Let us realize the savings first" Then, pf course, with term limits and a short legislative memory, they got away with not keeping that promise and the will in the legislature wasn't there to address it due to COMP LEGISLATION FATIGUE. (it was a large cumbersome bill)

Finally benetfits were increased approximately a year ago....and here we are cutting out the providers of those benfits again and limiting what was a 16,000 benefit to retrain people into gainful employment into a $4000 benefit for voc rehab. This will COST the state jobs and BTW...how many of you have retrained yourself for another profession for $4000.00 (while staving off creditors in an attempt to keep your home and feed your kids)?

This is a very bad bill for the grown men who have broken down to tears in front of me while trying not to lose everything.

[salin]

11. republican recall and rejection of democracy

strikes again.

[dfong63]

4. is this a good thing?

if so, please explain why.

[salin]

5. doesn't sound good to me ... need more information

though.

[nothingshocksmeanymore]

8. The anti -fraud efforts is a complete cannard

Everyone you talk to has anecdotal evidence of fraud but when push comes to shove it is because of what gets CALLED fraud.

The REAL FRAUD is their own doctors have cotrol of the case for 30 days. They send people who are seriously injured back to work saying they have no dosability which only tends to result in INCREASED injuries.

They also deny cases and during the time the cases are denied, the individual only gets benefits if they are certified for STATE DISABILITY which is a paycheck deduction that YOU PAY.

Then when the carrier is found liable, they reimburse EDD for pennies on the dollar, thereby stealing funds from a state fund paid for by LABOR AKA YOU.

Yeah there's fraud all right....they just don't go after them because it is difficult for them to PROVE with claims of work product and atty client privilege and because prosecuting a BIG GUY for fraud is much more costly and difficult than prosecuting a small fry that can't afford a lawyer.