6-25-12; PPP’s continue to move forward in IL WC and the IL State Chamber Remains on the Point of the Spear

In response to the Illinois Department of Insurance's proposed rules to implement the preferred provider program or PPP, the Illinois State Chamber finalized their thoughts and comments earlier this month. The PPP concept may provide sweeping savings to Illinois employers if/when the concept comes out of JCAR or the Rules Committee. The PPP provisions are important to helping employers provide quality healthcare to injured workers in order to lower disability/impairment, reduce future medical care and allow for quicker return to work which leads to better care for injured workers and lower costs for Illinois employers.

The IL State Chamber asserts our Illinois legislature intended the PPP addition to our IL WC At to benefit injured workers, encourage participation by competent medical providers and assist large and small employers by finding a balance between quality of care with access to post-injury care. We have told all of our clients to consider signing up with folks like HFN, Inc. that are very knowledgeable about the PPP concept and are sure to provide solid value—if you need information about HFN, Inc. send a reply or go to their website at http://hfninc.com/

During meetings with the Department of Insurance in 2011, our State Chamber leadership expressed concern the proposed rule's structure of coupling existing non-work-related healthcare PPP regulation with the new workers' compensation PPP creates extensive confusion and may lead to inconsistencies for how the Workers' Compensation Act applies to medical benefits for injured workers.

State Chamber leaders remain concerned critical issues remain that require further revision to recognize the distinct differences between medical provider networks for healthcare and medical networks for workers' compensation. Their written comments on the proposed rule identified where issues continue to exist and how the proposed rule fails to recognize those differences. Without revisions, they believe it will be very difficult for employers to realize

·         The intent of the law:

·         Quality healthcare services to injured workers and

·         Cost savings for employers.

June 11, 2012 ended the Joint Committee on Administrative Rules (JCAR) 45 day comment period to DOI. A second 45 to 90 days is required for review of the rule by JCAR. Following JCAR review, JCAR can allow the rule to proceed as proposed; recommend revisions or prohibit the rule from being adopted. A prohibition motion requires 3/5ths vote (8 of the 12 JCAR members). Either way, it may be moving to implementation by September 2012.

We continue to support the Illinois State Chamber and strongly recommend our readers consider joining this organization that remains on the point for your business’ interests. You can get more information on their website at www.ilchamber.org.