Synopsis: IL Governor Rauner Reappoints 11 Arbitrators, Says Goodbye to 20-Year Veteran Arbitrator Bob Williams. Let’s Hope IL WC Costs Continue to Drop.
Editor’s comment: Illinois Gov. Bruce Rauner on Wednesday reappointed 11 Arbitrators to the IL Workers’ Compensation Commission and thanked outgoing Arbitrator Robert Williams for his nearly 20 years of service.
Former Arbitrator Bob Williams, of Cook County, has practiced law for more than 30 years in government and in the private sector, and was a solid IL workers’ comp arbitrator starting in 1997. He previously served as chief of the Chicago Industrial Commission Bureau of the Office of the Illinois Attorney General, as legal counsel for the Illinois Office of the Comptroller and as corporate counsel in the City of Chicago’s law department. He also was an associate at Washington, Kennon, Bryant & Hunter, and holds an MBA from the University of Illinois, a JD from Loyola University and a BS from Le Moyne-Owen College.
Bob Williams was the only sitting IL WC Arbitrator who played competitive volleyball against your editor and other WC attorneys in the Chicago Bar Ass’n league. His departure doesn’t do much for the concept of “diversity” among the 40 hearing officers at the IWCC along with the Circuit and Appellate Court judges/justices across this state. We have no reason why Former Arbitrator Williams was not reappointed and hope it was as much his decision as it was the Governor’s. Bob was a solid and knowledgeable hearing officer who we are sure wanted to keep IL WC costs both reasonable, affordable and fair.
Reappointed as IL WC Arbitrators were:
- Kurt Carlson, of Cook County, a workers’ compensation attorney and arbitrator starting in 2004. Previously he represented both employers and injured workers at the law firms of Macey, Chern and Diab; Teplitz & Bell; and Power & Cronin. He served in the U.S. Army Medical Corps before earning his BA from the University of Wisconsin and a JD from the John Marshall Law School in Chicago. I consider Arbitrator Carlson to be fair and a solid hearing officer who always listens to both sides.
- Brian Cronin, of Cook County, a finance and business professional and an arbitrator beginning in 1996. Previously he was an independent and head trader, broker, trading floor manager and options specialist for several firms, including the Chicago Board of Trade, Barclays Bank and O’Connell & Piper Associates. He holds an MBA in finance and business policy from the University of Chicago, and an MBA in management and finance from the University of Notre Dame. Arbitrator Cronin is also a knowledgeable, professional and fair hearing officer with high ethical standards..
- Carolyn Doherty, of DuPage County, who has worked in workers’ compensation, insurance law and as an attorney with the IWCC. She has served as an arbitrator in the Cook and DuPage county mandatory arbitration systems on a rotational basis. She holds a JD from the John Marshall Law School and a BA from Marquette University, and previously worked as an associate at the law firms of Sedgwick, Detert, Moran and Arnold; Hanson & Peters; and Schoen & Smith. Arbitrator Doherty is brilliant in pretrials and we consider her to be a strong mediator of difficult disputes.
- Greg Dollison, of Cook County, a review coordinator for the IWCC for more than 20 years. He has moderated negotiations between employers and union representatives, and served as an arbitrator for the IWCC starting in 2004. Dollison has a BS in city and regional planning from the Illinois Institute of Technology and attended Roosevelt University. To our understanding, Arbitrator Dollison may be the last “non-attorney” Arbitrator in our state. He has a legal understanding he learned the hard way and does a solid job running his hearing room.
- Barbara Flores, of Cook County, who has worked as corporate counsel of Alden Management Services and previously in the labor and employment law department at the U.S. Postal Service. She also worked as an assistant attorney general in the labor and employment unit at the Office of the Attorney General and at the firm Rock, Fusco and Garvey, and the AIDS Legal Council of Chicago. She holds a JD from Chicago-Kent School of Law at the Illinois Institute of Technology, and a BS from the University of Illinois. Arbitrator Flores is both knowledgeable and fair to both sides.
- William R. Gallagher, of St. Clair County, who has more than 35 years of legal experience, including as a solo practitioner specializing in workers’ compensation law in Illinois and Missouri. He also worked as in-house counsel at the Kemper National Insurance Co., and specialized in workers’ compensation and products liability cases, and as an attorney at the Harry J. Nichols Law Office, working on workers’ compensation claims in Illinois and Missouri. Gallagher has a BA in political science and economics, and a JD from Southern Illinois University. We feel Arb. Gallagher does great work and brings top-notch professionalism to the job every day.
- Christina Hemenway, of Lincoln, who worked as an attorney specializing in workers’ compensation claims for more than 20 years. Hemenway has worked for Country Financial as a workers’ compensation claims attorney, and managed catastrophic claims and employer liability and coverage lawsuits. She is a member of the Illinois Chamber of Commerce’s Workers’ Compensation Committee, the Property Casualty Insurers’ Workers’ Compensation and Medicare committees, and the Illinois Advisory Committee for the Workers’ Compensation Research Institute. Hemenway is a graduate of Missouri State University and earned her law degree from the University of Missouri. Arbitrator Hemenway has a great legal mind and, as a claims manager, was behind many of the Appellate and Supreme Court rulings that define IL WC law.
- Edward Lee, of DuPage County, who as more than 30 years of workers’ compensation law experience. He served as a U.S. Army armor officer, representing soldiers or the Army in court martial cases. Lee worked in private practice specializing in workers’ compensation law, representing both respondents and petitioners, and was named an IWCC arbitrator in 1997. He holds a law degree from John Marshall Law School and attended Tulane University for his undergraduate studies. Arbitrator Lee is a quiet, knowledgeable and hard-working man who carefully considers all sides and makes his best judgment.
- Molly Mason, of Cook County, who has more than 25 years of workers’ compensation law experience. She served as a commissioner with IWCC starting in 2007 and as a staff attorney beginning in 2003. Mason previously worked at the law firms Corti, Freeman & Aleksy, and Burke & Burke, and has published several articles in the Illinois Bar Journal. She holds a JD from Loyola University and a BA from Harvard University. When she started at the IWCC, we feel Arb. Mason learned every single minute on the job; she is now brutally honest to the lawyers and a very solid mediator and hearing officer.
- D. Douglas McCarthy, of Macon County, who has more than 30 years of legal experience. At McCarthy, Rowden and Baker, McCarthy specialized in workers’ compensation and Social Security disability law, and has appeared before the IWCC, state circuit and appellate courts, and in federal administrative hearings. He graduated from Illinois State University with a BA in communications, earned an MA in public affairs reporting from Sangamon State University, and a JD from Southern Illinois University. Arbitrator McCarthy had such a strong background as a Petitioner attorney, many attorneys were concerned he would be biased—to the contrary, he is professional, careful and fair to both sides.
- Deborah Simpson, of Kane County, who as more than 25 years of government and law experience, including in the Office of the Illinois Attorney General’s administrative review/civil prosecutions unit. Simpson also was an attorney at the State’s Attorney’s Offices for Kane, Vermilion and Cook Counties, and was a part-time instructor at the Danville Area Community College. She holds a JD from the John Marshall Law School and a BA from DePaul University. Arbitrator Simpson is unsurpassed in ethics, professionalism and hard work.
As we approach the publication of the 2016 Oregon WC Premium Analysis, we are confident the IL WC Arbitrators reappointed by our Governor “get it” and are working to have IL WC reach a middle ground among the U.S. workers’ compensation programs. We will continue to watch and vet them every day we are working as defense attorneys and reporting their strengths and any concerns to our readers.
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Synopsis: WCRI Report Shocks Lots of State WC Systems Due to Wide Variances in Work Comp Hospital Costs.
Editor’s comment: As we have advised, IL WC doesn’t have high medical costs compared to our sister states.
In their recent study, WCRI found rapidly rising hospital costs in the treatment of injured workers receives attention from public policymakers and system stakeholders in many states. To assist in better understanding these costs, the Workers Compensation Research Institute (WCRI) released their new national study, Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 5th Edition, that compares hospital outpatient payments across states and monitors the impact of fee schedule reforms.
“This report found that hospital outpatient payments per surgical episode varied significantly across states, ranging from 69 percent below the study-state median in New York to 142 percent above the study-state median in Alabama in 2014,” said Dr. Olesya Fomenko, co-author of the study and economist at WCRI. Variation in the difference between average workers’ compensation payments and Medicare rates for a common group of procedures across states was even greater—reaching as low as 27 percent (or $631) below Medicare in New York and as much as 430 percent (or $8,244) above Medicare in Louisiana. We have included a comparison of workers’ compensation hospital outpatient payments and Medicare rates,” said Ramona Tanabe, executive vice president and counsel at WCRI. “Medicare rates capture payments to hospital outpatient providers for similar services by a large payor, and the report offers an additional benchmark that helps states better understand their hospital payments.”
The following are some major findings from the study:
· States with no workers’ compensation fee schedules for hospital outpatient reimbursement had higher hospital outpatient payments per episode compared with states with fixed-amount fee schedules—63 to 150 percent higher than the median of the study states with fixed-amount fee schedules. Also, in non-fee schedule states, workers’ compensation paid between $4,262 (or 166 percent) and $8,107 (or 378 percent) more than Medicare for similar hospital outpatient services.
· States with percent-of-charge-based fee regulations had substantially higher hospital outpatient payments per surgical episode than states with fixed-amount fee schedules—32 to 211 percent higher than the median of the study states with fixed-amount fee schedules. Similar to non-fee schedule states, workers’ compensation payments in states with percent-of-change based fee regulations for common surgical procedures were at least $3,792 (or 190 percent) and as much as $8,244 (or 430 percent) higher than Medicare hospital outpatient rates.
· Most states with fixed-amount fee schedules and states with cost-to-charge ratio fee regulations had relatively lower payments per episode among the study states. In particular, for states with fixed-amount fee schedules, the difference between workers’ compensation payments and Medicare rates ranged between negative 27 percent (or -$631) and 144 percent (or $2,916).
The hospital outpatient payment indices compare payments (per surgical episode) for common outpatient surgeries under workers’ compensation from state to state for each study year and the trends within each state from 2005 to 2014. The analysis captures payments for services provided and billed by hospitals, and it excludes professional services billed by nonhospital medical providers (such as physicians, physical therapists, and chiropractors) and transactions for durable medical equipment and pharmaceuticals billed by providers other than hospitals. The analysis also excludes payments made to ambulatory surgery centers.
The 33 states included in this study represent 87 percent of the workers’ compensation benefits paid in the United States. The states are Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Wisconsin. Note the 2014 workers’ compensation and Medicare comparison is conducted for 31 states.
To purchase this study, visit http://www.wcrinet.org/studies/public/books/hci_5_book.html.