IAIABC Regulators Roundtable
At the 2018 IAIABC Annual Conference, regulators from the attending jurisdictions discussed some current issues of interest.
Challenge of Technology:
- There is a lot more we could be doing with regard to technology. Part of the challenge to this is an aging workforce (on the regulatory and judicial side) that is somewhat resistant to change.
- Technology requires funding and it is very challenging for state agencies to secure additional funding.
- Our state’s court system has already modernized to allow for online docketing and interaction with litigants. We should be able to modernize our entire system in a similar fashion. Funding from the legislature is needed to proceed.
- We need to keep injured workers in mind when it comes to technology. They need to still have the ability to access the system. If we go paperless, can they still file the required forms, etc?
- Smaller TPAs and carriers may not have the same technology as the larger ones. We need to make sure any new technology is accessible to everyone in the marketplace.
- While a state agency may have the technology to allow thing such as working from home, their human resource policies may not allow for this. Technology alone does not solve the problem.
- There is wide variation in the adoption of telemedicine among the states. Some have made significant progress in allowing this while others have made no effort in this area.
- One challenge for the states is examining the parameters telemedicine can be allowed. Will it be allowed for initial exams, follow ups, etc?
- States need to figure out how telemedicine services will be compensated and adjust their fee schedules accordingly.
- The United States can learn a lesson from Australia as they have been using telemedicine for years in their group health and workers’ compensation systems. One area they are seeing significantly increased use are in the area of mental health treatment.
- Many states have fee schedules that are based on Medicare reimbursements. Medicare is currently looking at making changes to their reimbursement models so there is concern on the impact this will have on fee schedules. States don’t automatically adopt changes to the Medicare model as this has to flow through the legislative or rule making process. States are taking a wait and see approach on this issue as Medicare talks frequently about making changes but often this does not materialize.
- Some states require adjuster licensing while others do not.
- Some of the states that require adjuster licensing also require continuing education to maintain that license. A small number of states require the continuing education.
- Regulators are concerned with adjuster training, case loads, and the jurisdictional knowledge of multi-state adjusters.
- Turn over of adjusters often causes compliance issues.
- Few states require in-state handling of claims, but those that do feel strongly about this issue. Many of these are smaller population states that have concern about their claims not getting sufficient attention in a regional claims office.
- There are few states with mandatory vocational rehabilitation.
- Those with vocational rehabilitation are looking at how to make the programs more impactful in terms of driving actual return to work. This is not usually monitored.
- Too often vocational rehabilitation costs are a throw-in for settlement and are not used for the intended purposes.
- Germany has had active vocational rehabilitation as part of their workers’ compensation system since it’s inception. This includes training programs and the costs of these is not capped. The German system has a tremendous focus on getting injured workers back to work in some manner.