Synopsis: State of the State of IL Work Comp From Gene Keefe’s Perspective.
Editor’s comment: Welcome to the New Year, Folks! Understanding IL Work Comp as a legislative/administrative concept started shortly after the Cherry, IL Mine Disaster in 1909, our work-injury/exposure-compensation system has survived 110 years of growth. Where is it going from here?
New Multi-Zillionaire Governor
Short term, the State of Illinois will have a new Governor on Inauguration Day Jan. 14—JB Pritzker who is the billionaire heir to the Hyatt Hotel business. As I reported, he has done as much as anyone possibly could to make turn the State of Illinois into a one-party government and his political party used his funds to now have strong “super-majorities” in the IL House and Senate. In short, the only thing limiting the Democrats in Illinois state and most local governments is their imagination and drive. One-party governments are dysfunction, if you look at how horridly run the City of Chicago gov’t is. It is possible the Republicans may find a better zillionaire candidate for the next gubernatorial race in around four years so it is hard to predict this State will forever be a one-party gov’t but you never know.
To my understanding, Illinois State Democrats can easily and quickly change the IL Constitution starting in two years. I join with the editorial board of Crain’s Chicago Business to voice the hope the power of new Governor Pritzker along with our great Senate President John Cullerton and House Speaker Michael Madigan will be focused on stopping/ending State and local fake government pensions from basically robbing taxpayers with their currently unfundable format. The so-called “pension clause” in the current IL Constitution was drafted by an Illinoisan and can be ended by Illinoisans to save our State from eventual bankruptcy. You can’t have government workers contribute $100,000 over their careers to their fake government pension plans to then receive literally millions from taxpayers in return after leaving gov’t employ. If you don’t believe me about fake gov’t pensions being the equivalent of winning the lottery at your expense, send a reply. The same thing goes for government workers’ completely unfunded healthcare plans in retirement. The current combined deficits for both the fake gov’t pension plans and healthcare coverage for gov’t retirees is well over $200B and rising by the millions every minute of every day.
Going back to workers’ comp
The Illinois Workers’ Comp Commission is currently headed by Chairperson Joann Fratianni. I consider her an excellent administrator and fair to all sides. I am sure the secret powers that be who run the IWCC have already interviewed candidates and Joann may be replaced in the coming days/weeks. I salute her hard work and pluck for the time she has been in the “eye-of-the-WC-hurricane” at the IWCC. Things have run quietly and professionally under her aegis. In other news, I am sure former IL WC Arbitrator Nancy Lindsay left her post effective yesterday and I/we wish her the best in any new endeavor she enters. At least 11 other Commission posts are in the lurch as you read this—I will continue to report changes as the news comes out.
Under the outbound administration and Governor, IL WC insurance premiums have dropped to the middle of the U.S. pack—the State of Oregon’s every-other-year survey indicates Illinois WC is now No. 22 among the fifty United States. I almost hate to write about it because I am worried the forces of ITLA or the IL Trial Lawyers Ass’n may be focused on changing the law or administrators to get Illinois back into the top ten or even top five in WC premiums, as we were after Blago-Now-in-Jail brought in lots of liberals and radicals to run the IWCC. Let’s hope Governor Pritzker will keep things in the middle and encourage existing businesses to remain here and new businesses to start here. Please also note some goof at ITLA is still claiming those unnamed WC insurance carriers aren’t passing the WC cost savings along to their customers—“DUH”—the reason IL WC is now at No. 22 is because of lower WC insurance premiums. In short, the urge of some Democrats to create an hilariously tiny WC insurance carrier to make WC premiums competitive is gone. We hope they don’t continue to try to waste $10M in the fashion that was vetoed by our outbound gov.
Higher Minimum Wage Will Change IL WC
Governor-elect J.B. Pritzker repeatedly indicated he would like to move quickly to begin raising the minimum wage in Illinois with an eventual goal of raising it to $15 an hour. Pritzker said raising wages and the standard of living in Illinois is a priority. But he also said he would look for ways to minimize the impact of that wage increase on small businesses, without specifying what steps he might take to accomplish that. Pritzker has not indicated how long it might take to gradually raise the wage to $15 an hour. From a workers’ comp perspective, the higher wages go, concomitant wage replacement benefits like TTD and TPD will also rise for injured workers. The impact of a higher minimum wage will change the nature of wage loss differential claims in some industries—please watch this space for guidance on reserving and managing such claims as things move forward.
Happy New Year!!
Let’s keep our fingers crossed to see our new Governor and Democratic House and Senate use this opportunity for good and not evil. Some day, someone is going to address the fact out State and local Gov’ts waste money with duplicative and unnecessary agencies/jobs and silliness. IL State Gov’t has 88 agencies with 88 Dep’t Heads, Ass’ts to the Dep’t Head and HR peeps, etc. Lots of other states have combined agencies and shrunk staff. Cutting out unneeded and duplicative state jobs and using computers to streamline things would save taxpayers billions. If Hyatt Hotels were run in the fashion IL State Gov’t is run, they would be out of business in a year. Let’s see if JB Pritzker has the chops to bring efficiency and effective management to our State gov’t and become the best governor in modern history.
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Synopsis: Workers' Comp Drug Formulary Coming to Indiana Starting Today! Research and reporting by Kevin Boyle, J.D., KCB&A’s Indiana WC defense team leader and Gene Keefe, J.D.
Editor’s comment: Indiana Senate Bill 369 was signed into law. This new law requires implementation of a workers’ compensation drug formulary based on the Official Disability Guidelines (ODG) Workers' Compensation Drug Formulary Appendix A, effective today, January 1, 2019.
Under the formulary requirements, reimbursement for ODG-designated “N” drugs will not be permitted without prior approval from the employer. However, to address pre-existing drug therapy, if the injured/disabled worker began use of the “N” drug before July 1, 2018 and continues use after today, January 1, 2019, reimbursement will be permitted under the law until January 1, 2020. There is an additional authorization exemption in cases of medical emergency.
The authorization process includes submission of a request by the prescriber to the employer which contains their reason for requesting use of the “N” drug. If the employer does not approve the medication(s), they will be required to send the request to a third party certified by the Utilization Review Accreditation Commission or URAC to make a determination on the request. The employer will be required to notify the prescriber and injured/disabled worker of the UR determination not more than 5 business days after receiving the request. Failure to provide that notice leads the prescriber's request to be considered approved and reimbursement authorized. If the determination is to deny, the injured/disabled worker will be able to appeal to the IN Worker's Compensation Board for a final determination.
We will continue to watch the Indiana Workers’ Compensation Board as they work to implement the new formulary requirements. Further communications for our IN clients on this new formulary will be forthcoming. For now, we urge our clients to review the legislation and become familiar with the requirements. Information on the bill, including the final text, can be viewed online here: https://iga.in.gov/legislative/2018/bills/senate/369.
Send any questions or concerns about any IN WC issue to Kevin Boyle at firstname.lastname@example.org.