According to the National Council on Compensation Insurance (NCCI) rate adequacy, medical inflation, the state of the economy, and the shifting workforce were marked as the top issues.
A new survey from NCCI reveals top concerns for workers’ compensation executives as 2023 swiftly approaches. Rate adequacy, medical inflation, the state of the economy, and the shifting workforce were marked as the top issues.
- Rate Adequacy – Despite premium rates and loss costs declining for years in most states, insurers have expressed uncertainty for the next five years regarding rising inflation pressures and the growing costs of medical treatment. These factors, coupled with a momentous shift in the labor market, carriers say they do not have all the pieces to properly evaluate how these socio-economic changes will impact the market.
- Medical Inflation – Although medical prices contribute to general inflation, these services usually do not grow at the same rate. Not all medical services are seeing costly increases, particularly workers’ compensation prescriptions (See our Part I & Part II blogs on inflation). While medical advancement in technology and treatments is rapidly evolving, workers’ compensation executives believe these innovative pathways for clinical services could be a high expenditure.
- The State of the Economy – Following rapid economic growth in 2021, inflationary pressures and supply chain issues have stunted economies worldwide. Economic uncertainty is affecting key industries such as tech and real estate. Meanwhile, sectors like education, manufacturing and healthcare are scrambling for workers. For workers’ compensation, the shift to remote work and the great “reshuffle” are areas to watch going into 2023. Research shows that inexperienced new hires pose a high risk of injury, and with worker shortages in several sectors, injury frequency could rise.
- Remote Work- Although a few states, such as Ohio, have taken action to limit the eligibility of work-from-home injuries for workers’ compensation, other states re-emphasized that remote workers can qualify for benefits if proper evidence and documentation is presented.
Psychiatric patients face barriers to access prescriptions.
Despite new clinical guidelines from the CDC calling for a more individualized approach to meet patient needs, several patients attempting to secure psychiatric drugs are being denied their prescriptions. Wholesalers are notifying some pharmacies that they will be cut off from distributing all controlled substances after filling prescriptions for Adderall and Xanax, medicines commonly prescribed for treating ADHD and anxiety. The wholesalers say the ban is in place to stop practitioners who frequently prescribe/dispense a sedative and stimulant to the same patient. The American Psychiatric Society says such a combination is clinically valid and routinely dispensed for years to manage specific comorbidities. Due to the wholesaler's alteration, psychiatrists worry that they will be blocked if they continue to prescribe such medication, even if it is in the best interest of the patient’s treatment. The head of the Southern California Psychiatric Society (SCPS) calls the trend detrimental “to many patients who have comorbid anxieties along with ADHD, or sleep issues along with ADHD," believing this circumstance to be “a trickle-down effect from the opiates.” The CDC guidance referenced by SCPS originally issued in 2016, recently went through a comprehensive revision process to correct previous language in November of this year after numerous health institutions and advocacy groups called for improved access to medication for chronic and intractable pain patients.
New findings from the state Office of the Judges of Compensation shows that carriers are responsible for increased legal fees in the Sunshine state.
A new report from the Office of the Judges of Compensation claims indicates that injured workers spent 1.9 percent less on attorneys in 2021-2022 than the year prior, while carrier's defense fees increased by 5.6 percent. More than 53 percent of all attorney fees were paid to defense attorneys. In all, $504,243,763 were paid in legal fees in a system that is supposed to be self-executing. This figure results in a 2% increase over $494,505,716 spent on plaintiffs’ attorneys and defense attorneys in 2020-2021. Although workers’ compensation cases increased in 2021-2022, the overall number of petitions filed were below pre-covid levels. 31,000 workers’ compensation cases were filed, up 3.8 percent from last year, with nearly 72,000 petitions, a 3 percent increase. Injured workers can file multiple petitions attributed to a single incident.
Legislative leaders are looking to enhance cancer presumptions for state first responders.
HB1408 and HB1410, recently filed in the General Assembly, look to improve presumptions for state first responders. HB1408 adds certain cancers eligible for coverage under workers’ compensation for all firefighters (salaried/volunteer) and members of the Department of Emergency Management. Added cancers that the presumption will cover include bladder, melanoma, non-Hodgkin’s lymphoma, and thyroid. If passed, the bill would become effective on July 1st, 2023. However, the bill would not be retroactive and only apply to injured workers who filed after July 1st, 2023. HB1410 would add arson investigators, bomb squad members, and any personnel of the state police who would handle hazardous or radiological materials to the list of occupations eligible for state cancer presumptions. The bill would require officers applying for the presumption to have a minimum of five years of service to qualify.
Note: To access audio for the LWU please access audio via Adobe by a.) choosing “view” at the top menu b.) click “activate read out loud” c.) click “read to end of the document”.
Stay connected to all relevant information in workers' compensation and pharmacy by subscribing to our weekly newsletter. For last week's wrap-up, please click here.