Complete Story
04/28/2008
OSCA Testifies Before BWC Board
On April 24, 2008, Woody Woodward, OSCA Executive Director, testified before the Ohio Bureau of Workers' Compensation Board of Directors.
Woodward was 1 of more than 30 individuals to testify for this first Health Care Public Forum. OSCA Board Chair Dr. Judson Sprandel II and OSCA BWC Committee Co-Chair Otto Schmidt attended with Woodward and OSCA Assistant Director Dixie Russell. "Interesting that all providers are experiencing our same issues and concerns," stated Sprandel.
The testimony focused primarily on the issues of steerage of injured workers and IME concerns.
The OSCA will continue to work with the BWC to ensure that all of the issues which DCs face in the system are raised and addressed.
The text of Woodward's testimony follows:
Thank you Mr. Chairman and members of the Board. I am Woody Woodward, Executive Director of the Ohio State Chiropractic Association and I am pleased to be with you this morning to briefly discuss the care which our nearly 1,000 member doctors provide to Ohio's injured workers and to address some of the barriers to care which injured workers face when seeking chiropractic care in the system.
Chiropractic physicians throughout Ohio provide safe, conservative, cost effective treatment to tens of thousands of injured workers. In many of these cases, chiropractic care alone effectively addresses the workers injuries. This care often renders riskier and higher cost treatment protocols including surgery, spinal injections and prescription drugs unnecessary. Numerous published studies suggest that spinal manipulation performed by chiropractic physicians is at least as effective for eliminating low back pain as prescription drugs, injections or surgery. Still, Ohio injured workers face some barriers when seeking chiropractic treatment for their work-related injuries.
First, the OSCA is concerned about the steerage of injured workers away from chiropractic physicians. Not a week goes by when we are not made aware of injured workers who make it in to see a chiropractic physician only after being discouraged from doing so by an employer, or worse yet, an MCO. During the last few years, we have collected a number of employee notices which suggest that an injured worker seek treatment at a company approved occupational medical center. We believe strongly that injured workers are being steered by some employers toward facilities which have the best interests of the employer in mind. This steerage at least makes it difficult for injured workers to choose their own doctor-a fundamental element of HPP. We would appreciate the opportunity to work with the Bureau and the employer community to devise a plan which helps to educate injured workers and employers relative to injured worker rights in seeking medical treatment.
Second, the peer review system for claims is in need to reform. Constant reviews, file reviews and hearings cost the system money and inconvenience injured workers. In most cases, care is ultimately authorized, however it is only authorized after a number of exams, file reviews and hearings. I am aware of one claim- which is less than two years old-that has been the subject of no fewer than sixteen BWC reviews and four Industrial Commission hearings on the issue of chiropractic care alone. After repeated denials in BWC or MCO reviews, all questions were ultimately settled in favor of the claimant at the IC-the sixteen reviews simply representing an unnecessary expense of time and money. The review industry has become a subset of the chiropractic profession in Ohio. It is a self-perpetuating industry where more reviews and more denials equal more compensation for the reviewer, more cost to the system, more hassle for the injured worker and delayed income for the provider. The BWC is urged to look closely at the claims review system and follow the lead of other states by requiring reviewers to spend a reasonable amount of time (50%) in actual clinical practice and establishing quality assurance and accountability programs for claims reviewers. Our members deserve to know that their claims for payment are truly being reviewed by their peers, rather than by doctors who have essentially gone to work for MCOs and no longer treat patients.
Third, I have stated in numerous conversations with the previous medical director over the past two and a half years our desire to do whatever it takes to work with the Bureau to address any concerns or barriers that prevent the system from having full confidence in the chiropractic profession treating Ohio's injured workers. This could include educating the BWC and MCOs on standard chiropractic treatment protocols, establishing guidelines for supportive care and working to address issues of doctors who practice outside of the protocols or are gaming the system. The HPP will work when all interested parties work together to provide high quality, proper and cost effective care to the injured workers of Ohio.
Again, I appreciate the opportunity to be with you this morning. Chiropractic care provides low cost, high quality, drug free and non-invasive care to the injured workers of Ohio. The Ohio State Chiropractic Association is committed to doing all that we can to insure that those injured workers receive the quality care they need and are able to return to the workforce as quickly as possible. We look forward to continuing to work with you and BWC staff to address the barriers which we believe exist to those objectives and to striving together as we move closer to them.
