6/28/2011
The following reforms are scheduled to be signed into law on June 28, 2011.
Here is a summary of what will become law on July 1, 2011.
- Introducing to Illinois statutes for the first time AMA guidelines to determine impairment is important to introducing greater certainty and objectivity to Commission rulings regarding disability. It adds medical based records as an additional subjective factor for consideration to age, occupation and future earnings for consideration by non-medical arbitrators. A win for employers. While the new law contains AMA guidelines, it also provides sufficient “flexibility and ambiguity” for the plaintiff’s attorneys to effectively dilute the value.
- Introduces to Illinois statutes for the first time preferred provider networks and allows limited employer direction of care for employee’s choice of doctors. Employer directed health care is proven to save costs and yield better outcomes. Depending upon how well the employer handles the task this can be a win for employers. However, the program value is substantially diluted by allowing employee to easily opt out of the network care at any time, thus assuring continued appearance of “doctor shopping” and related out of network referrals for high cost procedures.
- Utilization Review was first introduced in Illinois statue in 2005, but has proven to be generally ignored and ineffectual. The new law strengthens the statutory provisions for UR and may be used to control out of network medical expenses. A win for employers.
- Medical fee schedule reduction by 30%. Caps medical implant costs. Allocates out of state medical costs to resident Illinois County. Caps doctor dispensed Rx. Reduces Geo-zips to match Medicare regions. This accounts for most of the $500 million estimated savings for employers. A win for employers.
- Moderate Caps carpal tunnel hand injuries. A win for employers.
- Caps on wage differential awards. Although, limited in application it is a win for employers.
- No significant rollback or reduction in worker benefits except for curbs on medical costs. A win for organized labor.
- Language on drug & alcohol intoxication is not strong enough for employers. Using “sole cause” instead of “proximate cause” does not adequately place the responsibility on the employee where WC benefits are concerned. A gesture of limited value.
- All Arbitrators are terminated as of July 1, 2011, and must re-apply for their positions. This provision seems to be focused on eliminating Arbitrator Teague and Arbitrator Dibble. Also, for the first time, there is a requirement that all Arbitrators must be licensed attorneys.
For more information or if you have any questions please contact Brad Young at 314-421-1850, or jbyoung@robertsperryman.com