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By Travis E. Poling
San Antonio Express-News Business Writer
Friday, January 14, 2005
State bill outlines workers' comp fix
Texas Senate leaders laid out their fix for workers' compensation insurance woes Thursday, introducing legislation that would cut in half the wait time for injured workers to qualify for benefits.
The proposal, called Senate Bill 5, also would increase benefits by 10 percent and establish a network of doctors and other providers to get better care for those injured.
The proposal from Lt. Gov. David Dewhurst and Sen. Todd Staples, R-Palestine, reworks the Texas Workers' Compensation Commission into an agency led by a single commissioner. It also strengthens the ability of the insurance commissioner to keep premiums under control.
A separate proposal from the Sunset Advisory Commission chairman, Rep. Burt Solomons, calls for the dissolution of the Texas Workers' Compensation Commission and shifting most of the function to the insurance department and Texas Workforce Commission.
But both plans share a desire to fix a system that legislators, employers and workers say doesn't provide adequate care or get people back to work.
"It's very important that we lower workers' comp rates ... but the injured worker is our focus," Dewhurst said. "Some 34 percent of injured workers never return to their jobs. That's a huge problem to our employers. They're losing trained workers."
SB 5 also is aimed at creating networks of doctors and other health providers to treat worker injuries in a system that works the same way as regular employer-sponsored health plans.
Staples said the networks would help return doctors to the fold by taking the hassle out of the system that caused many to stop taking workers' compensation patients.
He also said the single-commissioner agency would be a better administrative model that "allows the strongest level of accountability."
Terry Frakes, senior vice president of Texas Mutual Insurance Co. — the state's largest workers' comp provider with about 26 percent of the market — supports the reform measures.
"If there is a savings from what they put into place, then we will certainly return that to our policyholders" in the form of lower rates, Frakes said.
Texans for Workers' Compensation Reform, a coalition of industry associations, said the current system is one of the worst in the nation and backed Staple's bill.
"Our workers' compensation system is broken, pure and simple. It suffers from skyrocketing costs, mediocre care and a poor record of getting injured workers back on the job," said Dan Hagan, president of the group.
The cost of lost time from worker injuries has risen to nearly $13,000 per claim — much higher than most of the states studied by the Workers' Compensation Research Institute.
Groups representing workers and doctors are taking a more cautious approach to the proposed law.
Texas AFL-CIO President Emmett Sheppard said the union group will propose an alternative to the single commissioner — who he dubbed a "workers' compensation czar" — because such a plan would silence an independent governing voice.
"In workers' compensation legislation, the devil is in the details," Sheppard said. "We are examining the bill with an eye toward whether the medical networks the bill would set up provide a broad enough choice of quality medical care providers."
San Antonio pathologist Dr. David Henkes, chairman of the Texas Medical Association's Workers' Compensation Committee, also questioned the use of networks, but applauded measures that would get doctors paid faster by the insurance firms.
"We don't see networks as the silver bullet to fully reform the failed workers' compensation system in Texas ," Henkes said. "We do applaud the requirement to institute the regulations already in place at the Texas Department of Insurance regarding commercial health plans.
"These include, specifically, prompt pay and requiring any health plan network to include appropriate specialties located reasonably close to the injured worker."