7-10-2018; Jay Shattuck and State Chamber Reply to Dr. David Fletcher's Comments on IL Senate Bill 904; John T. Bowman and Steve Williams, RIP and more

Synopsis: Jay Shattuck and Our IL State Chamber Reply to Dr. David Fletcher’s Comments on IL SB 904.

Editor’s comment: I received permission to reprint these comments and I am doing so with minimal editing. I will point out Jay Shattuck and IL State Chamber President Todd Maisch are among the sharpest folks in this State when it comes to understanding legislation, in work comp and many other fields. I consider these comments required reading for any doctor, hospital administrator or anyone else who cares about the medical side of IL Workers’ Comp. I encourage my readers to join the IL State Chamber of Commerce that is the leading voice for Illinois business and all taxpayers in Springfield. For more information, visit their website at www.Ilchamber.org.

From Jay Shattuck:

In the recent commentary provided to you and your readers by Dr. David Fletcher, there is little to argue with about his thoughts on the friction in our workers’ compensation system between medical providers and employers paying for medical care. Yes, the court has decided that medical providers do not have a mechanism to collect the 1% per month interest for untimely payment of medical bills and one should be created. Also, there is no justifiable reason for payers to require paper submission of medical bills by medical providers. These seem to be the two main issues that he and many in the medical profession believe need to be remedied to improve the system and retain doctor care for workers’ compensation injuries. What Dr. Fletcher’s commentary and those interests supporting SB 904 fail to explain though is how SB 904 will implement the remedies and the negative impact SB 904 will have on employers responsible for paying of medical services in  our workers’ compensation system.

Like the Greeks were able to fool the Trojans, SB 904 is a Trojan horse piece of legislation. Here’s why:

SB 904 could apply to all medical bills, not just undisputed bills…proponents of SB 904 argued that the changes will only apply to undisputed medical bills meaning that the 1% per month interest penalty would be required on any undisputed bill not paid within 30 days. However, nowhere does SB 904 limit the 1% per month penalty to undisputed medical bills. During legislative debate, legislative intent was offered to clarify that the intent was to limit the changes to undisputed bills. Okay, but any first year law student understands that when a court reviews a statute for its purpose, the court looks at the clear reading of the statute.  If SB 904 is signed into law, here is how the 1% per month penalty subsection will read:

(3) In the case (i) of nonpayment to a provider within 30 days of receipt of the bill which contained substantially all of the required data elements necessary to adjudicate the bill, (ii) of or nonpayment to a provider of a portion of such a bill, or (iii) where the provider has not been issued an explanation of benefits for a bill, the bill, or portion of the bill up to the lesser of the actual charge or the payment level set by the Commission in the fee schedule established in this Section, shall incur interest at a rate of 1% per month payable by the employer to the provider. Any required interest payments shall be made by the employer or its insurer to the provider not later than 30 days after payment of the bill.

 If, the changes in SB 904 were meant to apply only to undisputed bills, why was that not specified in the legislation?

The mechanism in SB 904 to collect the 1% per month is the circuit court… Medical providers argue that circuit court is the appropriate mechanism given the court's familiarity with bill collection issues. That may be true for ordinary business transactions, however the determination of whether a workers' compensation medical bill is compensable is far from ordinary. To decide whether the 1% per month interest penalty is due, a circuit court judge will need to determine whether the bill is for a workers’ compensation injury…is the injury work-related and whether the services were necessary. These are not issues that circuit court judges have expertise. The expertise is found at the Illinois Workers’ Compensation Commission. The initial determination of these issues has been the exclusive purview of the Commission and should remain there.

Arguing these issues at circuit court could prematurely expose the employer's defense arguments, providing an advantage to the petitioner's lawyer and harming the employer's case at the Commission. Also, it is possible that the circuit court could render a decision that is diametrically different than what is determined at the Commission. We believe going to circuit court will lead to more friction and litigation in our workers' compensation system, delaying decisions at the Commission for injured workers and employers.

Instead of circuit court, the Illinois Chamber and other business groups suggested that an award of the 1% per month interest penalty be determined in an expedited process at the Commission. Our proposal also allows a medical provider to petition the Commission and have a decision within 180 days as to whether the 1% per month penalty applies. If the medical provider is unsatisfied with the Commission’s decision, we allow an appeal of the decision to go to circuit court.

 SB 904 could limit access to medical records…Two important change proposed in SB 904 could place significant limits on what records an employer can obtain from a medical provider.

First, during the negotiations of the medical bill payment provisions back in 2005, the employer community was very careful in choosing the word “claim” versus “bill” regarding the requirement for the providing of “substantially all the required data elements necessary to adjudicate the bills” to trigger the 30 day clock. SB 904 in two, critical places changes “claim” to “bill”. These changes could be interpreted to limit records provided by a medical provider to only those needed to adjudicate the bill, (rather than the claim), for the specific services provided by the medical provider. This would trigger the 30 day, 1% per month interest penalty, clock requiring payment before an employer has additional information to determine the cause of the injury, whether it’s a work-related injury, and if the services were necessary.

SB 904 also requires the Department of Insurance to adopt rules to " ensure that health care providers are responsible for supplying only those medical records pertaining to the provider's own claims that are minimally necessary under the federal Health Insurance Portability and Accountability Act of 1996". Employers rely on the ability to access appropriate medical records from treating medical providers to determine causation and whether the injury is work-related. This change allows a medical provider to only provide medical records minimally necessary to pay for the services being billed.  

SB 904 creates new penalties for failure to comply with electronic claims process…A new penalty being sought in SB 904 is adding the 1% per month interest penalty for any reason there is a failure to pay or object to an electronically submitted bill within 30 days. This will add additional confusion as to how and when the 1% per month interest penalty applies.

A second, additional new penalty regarding electronic claims provides an administrative fine of up to $1,000 per each violation, not to exceed $10,000 for identical violations during a calendar year. We believe this is overly punitive and any penalty should be limited to intentional non-compliance or a pattern of failing to comply.

It should be noted that current law does not require a medical provider to submit its bill electronically. If a bill is submitted electronically the payor is obligated to accept electronic claims for payment. The Illinois Chamber has supported electronic billing and electronic payment since its inclusion in the statute in 2005 and believes the time is right to require all transactions to be electronic both from medical providers and payers. 

Illinois Chamber additional suggestions to expedite medical bill payments…We propose adding three provisions to SB 904 to help advance the expediting of medical bills and to reduce friction in the payment process.

• First, upon receipt of notice of injury, the employer is to provide the employee or the injured employee’s medical provider mailing and electronic addresses to send medical bills to. Adding this step will help prevent medical bills from being sent to improper addresses which results in unnecessary delay of bill payment.
• Second, an employer is able to timely process medical bills when the bills are submitted to the employer by the medical provider in a timely fashion. To that end, we recommend that a medical provider submit its bill to the employer within 90 days of providing its service to the injured worker.
• Finally, we recommend that an employer providing a compliant utilization review report has a rebuttable presumption that the 1% per month interest penalty does not apply to the services covered in the utilization report. This will incentivize a medical provider to cooperate with the employer in what is authorized and will reduce the friction caused when payment is sought for unauthorized services.

Dr. Fletcher indicates a crisis is at hand for medical providers in receiving medical payment for services provided in workers’ compensation. The Illinois Chamber hears his words and we agree medical care is a strong determinant of whether the injured worker is able to return to work, the timeliness of the return to work, the need for future medical care, and the impact on disability and indemnity costs to employers. However, SB 904 is not the solution and could dramatically tip the balance in favor of medical providers in a system where Illinois has the second highest medical fee schedule in the country for overall professional services and the highest in the country for major surgery services. SB 904 as sent to the Governor also will diminish an employer's ability to determine causation and whether an injury is work-related.

To show our good faith in solving the two issues Dr. Fletcher points out needing to be addressed, the Illinois Chamber and other business groups had SB 3617 and HB 5910  introduced at the end of May. As we said during the closing weeks of the Spring session when SB 904 was amended with the Illinois State Medical Association’s language, we are prepared to solve their issues with legislative changes that work for them as well as the employer community.

As your editor, I appreciate your thoughts and comments. I am happy to pass them along to both Jay Shattuck and Dr. Fletcher. Please also post them on our award-winning blog.

Synopsis: Steve Williams and John T. Bowman, RIP.

Editor’s comment: The IL WC community was mildly stunned to recently hear of the passing of these two stalwarts of our industry. John Bowman was a long-time friend and colleague of mine and will always be missed. I still remember his battles with a former law partner that I believe went all the way to the IL Supreme Court.

Steven Robert Williams was the son and law partner of the venerable Bob Williams at Williams and Swee—they were both fixtures at the Bloomington IL WC call for decades. Steve and I didn’t always agree but we did have great respect for one another. He left us much too early in his mid-40’s.

KCB&A sends our condolences to their friends and families.

7-2-2018; Janus Ruling Issued by SCOTUS; What Does It Mean to Workers’ Comp?; Lilia Picazo, J.D. on Important Exclusive Remedy Ruling; Matt Wrigley J.D. on Change to Michigan Application and more

Synopsis: Janus Ruling Issued by SCOTUS; What Does It Mean to Workers’ Comp?

Editor’s comment: I have a relative who is a school teacher. He told me his School District had a union for teachers but he didn’t feel they were effectively representing him and his fellow teachers. So, while he never joined the union, he was still required by law to pay “fair share” dues to the union. On their side, the unions did participate in collective bargaining and my relative got whatever benefits the union obtained for their dues-paying members.

If you aren’t sure, that was the issue presented to the U.S. Supreme Court in their Janus ruling—could government workers who don’t join government unions still be required to support the unions with “fair share” dues payment? Last week, our highest Court ruled such workers can no longer be required to make such payments if they don’t want to be in the union.

What does this mean to our country and more specifically, the State of Illinois? Well, I personally consider it a good thing. In my personal view, government unions have always been a bad idea. Believe it or not, one of the first folks to notice this problem was President Franklin Roosevelt. It was President Franklin Roosevelt’s judgment “the process of collective bargaining, as usually understood, cannot be transplanted into the public service.” In private-sector bargaining, unions contest management concerning the distribution of companies’ profits. In the public sector, government gets its revenues from a third party — you and I as taxpayers.

Allowing government unions to thrive and grow makes for high government salaries and benefits, like the fake and unfundable pensions many former IL government workers receive and are already crushing State, County and local gov’t budgets. I also feel most gov’ts in this State are vastly overstaffed due in part to government unions—this also adds to costs and high taxes.

Here are a couple of thoughts about government unions in this State:

• Forbes reported more than 30,000 Illinois teachers and retirees receive over $100K a year in compensation at an annual and ever-rising cost of $3.7B to taxpayers. Please note these retirees are guaranteed 3% annual compound increases that will double then quadruple their retirement pay if they live long enough (someone said such retirees are on a “fixed income”—not when they get guaranteed annual increases!)

https://www.forbes.com/sites/adamandrzejewski/2018/06/04/the-exclusive-100000-club-meet-30000-members-at-the-illinois-teachers-retirement-system-trs/#7e6010806129

• Every day of every year, Cook County Sheriff Tom Dart has to deal with 7 government unions—that is for just one County Department. That means Cook County administration may have to deal with 50-100 or more government unions.

• All of these IL gov’t workers vote with consistency and with one thought in mind—keep my pay, healthcare and benefits! No one seems to care about taxpayers—we have the highest combined income, real estate and sales taxes in the U.S. As fewer and fewer normal citizens vote, the impact of the thousands of gov’t-workers-voting-to-keep-or-increase-benefits has completely skewed our State, County and local governments away from efficiency and effective governance to enriching government workers.

What Does the Future Look Like for Workers’ Comp After Janus?

The defense team at KCB&A is sure there will be a decline in union membership following this ruling. Unions, like all entities, need money to operate, maintain and grow. The estimates I have seen indicate there may be 5.5 million workers who won’t have to continue to make “fair share” payments. That is a lot of money for gov’t unions to rapidly lose. The U.S. Supreme Court's decision in Janus continues the trend in the private sector, where more and more states have passed laws outlawing all forms of mandatory union dues. Currently, 28 States have laws that make it illegal to require workers to join a union or pay related fees as a condition of employment. But some of those state laws affect only the private sector. The Janus ruling will financially challenge all public-sector unions in the remaining states that allowed compulsory fees. We are sure this decision will lead to a further decline in the percentage of the American workforce that is unionized.

I assure my readers lots of Claimant lawyers live off those millions paid to gov’t workers for work comp benefits. If you are familiar with IL State Gov’t’s and Chicago’s WC programs, you will note literally millions are spent and misspent in managing and mismanaging those defense programs. You might think the jobs are “dangerous” due to the high level of “accident” claims and the higher level of attorney involvement. I don’t feel that is the case at all.

In my view, there is a very high level of involvement of Plaintiff-Petitioner lawyers due, in part, to contributions made to union stewards and friendly politicians. I make the rough estimation both gov’ts each spend about $150M a year in WC benefits—if all those benefits are paid at a 20% statutory clip to Plaintiff-Petitioner attorneys, that is $60M in fees!

One of my favorite stories was a successful Plaintiff lawyer who finally got the chance to make a presentation to a gov’t union local. When he got there, he was mildly stunned to learn he was the 23d Plaintiff-Petitioner lawyer presenting that day. Everyone of the presenters was expected to make a “contribution” to someone to get to the dais. Less money for unions may mean fewer lawyers involved in union claims.

Please also note some of the corruption in IL WC in years past was due to the shenanigans seen in the southern IL jails where unionized prison guards and lots of other gov’t folks, including at least one Arbitrator, were making bogus carpal tunnel syndrome claims. The guards were claiming the malady was from turning keys in locks and driving supposedly reluctant state vehicles. Lots of private workers started to make similar bogus claims—we felt this caused a major southern IL ammunition manufacturer to move their operations out of our state. Someone later put the kibosh on this silly stuff but it still shows you the gov’t sector can somewhat “poison” the private sector in IL WC.

I appreciate your thoughts and comments. Please post them on our award-winning blog.

Synopsis: IL Appellate Court Affirms Trial Court Order to Bar Plaintiff’s Common-Law Negligence Claim Against a Coworker Based on the Exclusive Remedy Provisions of the WC Act. Analysis by Lilia Picazo, J.D.

Editor’s Comment: In Peng v. Nardi, 2017 IL App (1st) 170155, the Illinois Appellate Court affirmed a trial court’s order dismissing Xiao Ling Peng (“Peng”) negligence claim against co-worker Lei Guan (“Guan”) for injuries sustained as a result of a 3-car collision.  

In June of 2014, Peng and Guan worked at a restaurant located in Hoffman Estates, Illinois. The employer provided Guan keys to a Ford passenger van to transport himself and other employees to and from the restaurant. The employer also paid Guan $600 a month for his driving duties and covered the cost of fuel. Guan was prohibited from using the van for personal use. He was prohibited from letting any other employee drive the van.

The employer initially told Guan where to pick up new employees, but Guan later chose the pickup and drop-off locations. Guan also chose the route to and from work based on Chicago traffic conditions.

On June 20, 2014, Peng was a passenger in the van when it was involved in a 3-car collision on northbound I-90. She suffered an injury to her hip. Peng filed a negligence suit against Guan and the two other drivers involved in the collision. Peng also filed a WC claim. The employer’s WC insurance carrier paid portions of her medical bills.

The trial court initially denied Guan’s motion to dismiss, but later granted Guan’s motion to reconsider and eventually dismissed Peng’s claims against him. The trial court found Guan was protected from liability in the common-law negligence action pursuant to the exclusive remedy provisions of the Illinois Workers’ Compensation Act.

Peng appealed arguing she was not in the course of her employment at the time of the collision. She also argued she filed a WC claim to protect her rights as the statute of limitations was approaching.

In affirming the trial court’s decision, the Illinois Appellate Court noted accidents generally occurring during travel to and from work are not considered to have arisen out of or in the course of employment under the exclusive remedy provisions of the Act. An exception exists; however, when the employer controls the means of transportation or method of transportation, thereby extending the risk and course of employment. The court explained Peng renounced control of her travel to and from work when she rode in the employer-owned and controlled vehicle driven by Guan.

Therefore, the court concluded the workers’ compensation system provided Peng exclusive remedy for her injuries against Guan and the employer as the accident occurred while Peng was in the course of her employment.

We want our readers to be aware that by providing company-controlled vehicles or transportation to and from work to employees may increase liability under the WC Act.

This article was researched and written by Lilia Picazo, J.D. You can reach Lilia 24/7/365 for questions about general liability, employment law and workers’ compensation at lpicazo@keefe-law.com

Synopsis: State of Michigan Revises Application For Mediation or Hearing – Form C. Research and analysis by our Michigan Defense Leader Matthew Wrigley.

Editor’s Comment: Michigan Department of Licensing and Regulatory Affairs (LARA) has revised Form WC-104C to include a checkbox to add any “non-employer entity.”

Prior to this revision Claimants were able to add a second employer but no mechanism was in place to add a separate entity as a party. The revised form will allow Claimants to more easily indicate their intentions and will aid LARA in the processing of such claims. All parties requesting mediation or hearing may commence using this form immediately.

We note Claimants who wish to settle for a lump sum cash payment must request the Workers’ Compensation Agency (WCA) file be sent from Lansing, the state capitol, to the appropriate hearing site. The assigned Magistrate will determine whether the settlement is just and proper. Form WC-104C is used to streamline the file request procedure and the box “Redemption Only” should be checked. Many claims involve disputes over medical care and such issues can sometimes be resolved through an informal telephone mediation process. Each party is provided an opportunity to discuss relevant issues and seek resolution. It is anticipated this will be more frequently utilized in disputes involving new opioid treatment rules.

This article was researched and written by Matt Wrigley, J.D. You can reach Matt 24/7/365 for questions about general liability, employment law and workers’ compensation at mwrigley@keefe-law.com

6-25-2018; What Is A Medicare Set-Aside and How May the New U.S. Senate Bill Help?; Sweeping New IL Medical Payment Legislation That, If It Becomes Law, Will Dramatically Impact All IL WC Claims

Synopsis: What Is A Medicare Set-Aside and How May the New U.S. Senate Bill Help?

Editor’s comment: I want to help all my readers on this complex claims topic. Lots of folks don’t understand the whole MSA or Medicare Set-Aside process. There is a new federal attempt to make it work better.

• First, What is a Medicare Set-Aside?

A Medicare Set-Aside is a trust-like arrangement set up to hold a portion of injury settlement proceeds for future medical expenses. A specialized company, like Sharpline Allocations, evaluates the injured worker’s future medical needs, recommends an amount to be set aside to cover future medical care and our federal government or their designated specialists approve the recommended amount. The funds are then either placed in the Medicare Set-Aside account in one lump-sum or the account is funded with a "structured settlement annuity" that will refill the account over time. In either case, the administrator of the Medicare Set-Aside trust may use the funds only to pay for medical care related to the injury, leaving Medicare or your private insurance free to provide coverage for medical expenses not related to the injury.

Medicare Set-Asides have been used for years in workers' compensation cases, and the federal government has an extensive set of reporting and monitoring rules. Recently, the federal government instituted a new set of reporting requirements for anyone who is responsible for compensating a personal injury victim, and many practitioners believe our government will soon require Medicare Set-Asides for all personal injury claims/settlements of any kind.

Currently, our federal government requires setting up a Medicare Set-Aside if the worker is a Medicare recipient settling a claim for more than $25,000 or if the settlement is for more than $250,000 and the worker can be expected to receive Medicare benefits within 30 months of settlement. This may happens when the worker receives Social Security Disability benefits, which has a 24-month waiting period before the worker can receive Medicare benefits.

• Second, U.S. Senate Bill Aims to Clarify/Simplify Frustrating Medicare Set-Aside Process

Observers feel a bill introduced in the U.S. Senate last week may clean up what has been a messy approach to Medicare set-asides. U.S. Senate Bill 3079, sponsored by Sen. Rob Portman, R-Ohio, and Sen. Bill Nelson, D-Florida, is a new and improved version of a bill introduced two years ago but which never emerged from committee.

The new bill would essentially force the Center for Medicare and Medicaid Services (CMS) to recognize provisions of states' workers' compensation laws, and would allow injured workers to pay Medicare's share upfront after a settlement instead of having to remember payments for the rest of their lives.

"This says, let's have a process that works for all parties involved," said Douglas Holmes, president of UWC Strategy in Washington, D.C., which lobbies and consults for businesses on unemployment and workers' compensation legislation. UWC led a coalition of insurance groups and claimants' attorneys that helped craft the bill. "We feel this reduces risks and reduces administrative costs."

While the process of handling Medicare's share in workers' compensation settlements has evolved over the past 50 years, it's never been formalized or codified, and remains inconsistent. "This will help injured workers finalize their claims and get money for settlements faster," said Ann Gray, assistant vice president of federal government relations for Property Casualty Insurers Association of America. The bill would also provide clear criteria for CMS to follow and would eliminate unnecessary reporting to the CMS, she asserts.

One problem with the current process is that in many cases, parties may have reached a potential settlement, only to have CMS reject the amount designated as a set-aside. This can completely change resolution and the settlement, particularly in major claims.

The new version of the Senate bill, known as the Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act of 2018, would address that by instituting a formal appeals process. CMS now has an informal review policy, but the reviews are limited and are done at the sole discretion of CMS. "A specific appeals provision is needed in statute," the analysis said. The suggested appeals process could "require more time and costs, so that could create another problem for carriers and employers," said Dan Anders, chief compliance officer at Tower MSA Partners. 

Under the current process, Medicare has been inconsistent in its acceptance of state requirements, experts asserted. "If a workers’ compensation settlement agreement is accepted, reviewed, approved or otherwise finalized in accordance with the workers’ compensation law of the jurisdiction in which such agreement will be effective, such acceptance, review, approval or other finalization shall be deemed final and conclusive as to any and all matters within the jurisdiction of the workers’ compensation law," the new bill reads.

Rather than manage the MSA for a lifetime, the new bill would give the worker the option of making a direct, one-time payment to Medicare. "Such transfer shall be made only upon written consent of the other party or parties to the agreement," the text of the new bill reads.

The measure also would require Medicare to set up a mechanism to accept the upfront payment, something the agency is not equipped for under current law.

Current statistics on set-asides nationwide were not available Wednesday, and Anders and Holmes said that a lack of data from CMS has been part of the problem. In 2013, The National Council on Compensation Insurance estimated workers’ compensation carriers throughout the country paid about $1.8 billion in Medicare set-asides that year. That number continues to rise with inflation and may be $3B annually at present.

Senate Bill 3079 has been assigned to the U.S. Senate Finance Committee.

Synopsis: Thoughts from Dr. David Fletcher on Sweeping New Legislation That Will Impact All IL WC Claims. This Will Be a Seminal Change That is a Must-Read for All Claims/Risk and Other System Participants.

Editor’s comment: Here is His Guest Commentary Published Without Editing | Doc Feels a Crisis Looms in the IL Workers' Comp System

Please Note Amendment 2 of IL Senate Bill 90 has passed by both IL legislative houses and has been sent to Governor Rauner for signature and enactment.  

This unprecedented bill replaces everything after the enacting clause. It amends the IL Workers' Compensation Act in relation to fees and electronic claims. The new bill, if it becomes law, requires a medical provider to bill an employer or its designee directly. This bill provides the employer or the insurer must send to the provider an explanation of benefits or EOB. The bill requires employers and insurers to pay interest to providers at the rate of 1% per month for services rendered on and after the effective date of this amendatory Act if the bill is not paid promptly. The bill authorizes providers to bring an action in circuit court to enforce the payment procedures with regard to services rendered on and after the effective date of this amendatory Act. The bill also requires the IL Director of Insurance to adopt rules to ensure that providers have the opportunity to comply with requests for records by employers and insurers. Finally, the bill imposes penalties upon employers and insurers that fail to comply with the electronic claims process. If Governor Rauner signs the bill, it will become law effective immediately.

By DR. DAVID FLETCHER

There's a crisis looming in our state's workers' compensation system. If allowed to fester, it will keep workers from receiving timely medical treatment for workplace injuries. It will delay workers' recoveries and their return to their jobs. And it will end up costing more for the very businesses and insurers seeking efficiencies in the system.

This crisis is not one you've heard about from the business and insurance communities. It's a crisis created by their failure to implement laws that have been on the books in Illinois for more than a decade.

As doctors who care for workers compensation patients, here are our concerns: Illinois law spells out the right for medical professionals to receive prompt payment for the care we give to patients with workplace injuries.

Just like any other business or profession, we need to be paid for that care we give, so that we can compensate our employees and keep open the doors of our medical practices.

Yet, many Illinois workers' compensation insurers completely ignore the prompt payment law. To date, there has been no remedy for doctors and other caregivers who remain unpaid for months and months at a time.

Furthermore, state law mandates that insurers accept electronic billing and documentation for workers' compensation claims. This expedites the process.

Yet, many insist on an obsolete paper-based medical billing system, which delays medical care to injured workers and wastes resources.

Add to this bleak reality a recent, alarming increase in delayed payments for already-approved workers' compensation medical care claims. The result is more and more physicians unable or unwilling to treat injured workers.

Since 2005, the Workers' Compensation Act has allowed medical professionals a late interest penalty for approved workers' compensation medical care.

Yet there is no way for doctors and others to enforce or collect this interest.

Even if the workers' compensation insurer approves care for an injured worker, it can and often delays payment for the medical treatment rendered. These delays can last for years.

A recent court ruling found that medical professionals can't even go to court to collect this interest.

Since the court decision, these payment delays have worsened to the point of doctors dropping out of the system.

What's lost in the current debate on workers' compensation policy is that medical professionals — the physicians, surgeons, hospitals and specialists — actually provide the care that supports our entire system.

Medical professionals are the ones who get injured employees back to work, reduce employer costs for time off and long-term injuries and work with employers to prevent work-related accidents from even happening in the first place.

We are often blamed for the system's ills, even though we are in a unique position to make that system function.

When workers are hurt on the job, they need timely access to dedicated physicians, surgeons and specialists to treat their injuries. We in the medical community stand ready with solutions to the problems that are threatening the health of our workers' compensation system.

It's time to pass legislation that forces workers' compensation insurers to start following the law. The alternative is having doctors and care centers rush to the exits.

I appreciate your thoughts and comments. Please post them on our award-winning blog. If you want me to relay your comments to Dr. Fletcher, I will do so without editing.