A brilliant reader pointed out there are lots of things the Illinois legislature did that aren’t going to happen for some time, if ever. In our view, it is part of the “crazy-making” that happens in every legislative session designed to misdirect our attention from more important things.
First, Governor Quinn and most legislators passed a law indicating they might actually do something about the scandal that is the continuing mismanagement of State of IL workers’ comp defense program. This amazingly screwed-up program is marked by claims adjusters that have an impossible number of claims to adjust, defense attorneys who roll over on every claim because they aren’t given evidence to present in defense of the claim and penalties/fees issued by state employees (Arbitrators) against state employees (claims adjusters) to the enormous benefit of the injured state worker and to the immense detriment of Illinois taxpayers. Over $100 million in WC benefits are paid to Illinois state workers every single year. Some day, they may actually do something about it in a state awash in a sea of red ink.
Second, we are all awaiting the PPP concept to allow great managers like Darren Stahulak of CorVel and David Kolb of HFN to do their magic and give Illinois employers control over medical care in this state. We are all awaiting JCAR or the Joint Committee on Administrative Rules to get their things together and issue final rules and allow implementation. The expected savings is $500 million or more.
Third, we are advised there is a reporting concept that isn’t going to match the statute. New Section 29.2 of the IL WC Act says (in pertinent part):
(b) The Director of Insurance shall promulgate rules requiring each insurer licensed to write workers' compensation coverage in the State to record and report the following information on an aggregate basis to the Department of Insurance before March 1 of each year, relating to claims in the State opened within the prior calendar year:
(1) The number of claims opened.
(2) The number of reported medical only claims.
(3) The number of contested claims.
(4) The number of claims for which the employee has attorney representation.
(5) The number of claims with lost time and the number of claims for which temporary total disability was paid.
(6) The number of claim adjusters employed to adjust workers' compensation claims.
(7) The number of claims for which temporary total disability was not paid within 14 days from the first full day off, regardless of reason.
(8) The number of medical bills paid 60 days or later from date of service and the average days paid on those paid after 60 days for the previous calendar year.
(9) The number of claims in which in-house defense counsel participated, and the total amount spent on in-house legal services.
(10) The number of claims in which outside defense counsel participated, and the total amount paid to outside defense counsel.
(11) The total amount billed to employers for bill review.
(12) The total amount billed to employers for fee schedule savings.
(13) The total amount charged to employers for any and all managed care fees.
(14) The number of claims involving in-house medical nurse case management, and the total amount spent on in-house medical nurse case management.
(15) The number of claims involving outside medical nurse case management, and the total amount paid for outside medical nurse case management.
(16) The total amount paid for Independent Medical exams.
(17) The total amount spent on in-house Utilization Review for the previous calendar year.
(18) The total amount paid for outside Utilization Review for the previous calendar year.
We assume this information may be of interest when it is published. The Department shall make the submitted information publicly available on the Department's Internet website or such other media as appropriate in a form useful for consumers. At present, the Illinois Department of Insurance hasn’t promulgated the required rules. We will all watch to see if the Department will promulgate the rules any time soon. Such rules may have to go through the JCAR process which is the Joint Committee on Administrative Rules and the rules haven’t even been written yet.
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