Illinois Gov. Bruce Rauner has vetoed, with recommended changes, a workers’ compensation measure that would have allowed for interest to be paid on delayed payment in disputes between insurers and medical service providers.
In his letter explaining his veto action, Rauner stated: “SB 904, as approved by the General Assembly, proposes changes to the Workers’ Compensation Act to: 1) provide to medical providers a mechanism for collection of the 1% per month interest penalty provided by Section 8.2 of the Act; and 2) provide penalties for the Department of Insurance enforcement of the electronic claims transaction requirements under the Act.”
While he has advocated reforms in the workers’ comp system that would provide “provide relief to employers from the high costs of our system,” the governor said SB 904 is not the answer. The legislation does not enact meaningful reform and does not provide changes that would bring Illinois’ workers’ comp costs in line with other states, he said.
According to a statement released by the American Insurance Association, which opposed the bill, “SB 904 would have allowed medical providers to take insurers to court whenever there was any dispute about a medical bill, likely increasing the time it would have taken for a claim to be settled and the cost of settling the claim.”
Steve Schneider, AIA vice president for state affairs, Midwest region, stated that the association is “pleased that the governor has chosen to put injured workers’ medical treatment ahead of doctors’ payments,”
In his letter to lawmakers, Rauner said that the bill tips the balance of the system in favor of medical providers and “does nothing to assist injured workers.” He also said it “diminishes an employer’s ability to determine causation and whether an injury is work-related.”
The governor said he would like to establish “a procedure through the Illinois Workers’ Compensation Commission which would result in more timely determinations of interest payments for all concerned.”
Both the Illinois State Medical Society and the Illinois Health and Hospital Association had endorsed the bill, especially in regard to the provisions allowing the collection of interest on late payments. In a statement posted on the ISMS website, the groups said while delayed payment has “always been an issue in treating injured workers,” there has been an “alarming increase in the delay of payment for ‘pre-authorized’ workers’ compensation medical care.” Because medical providers are unable to collect interest, they are left “on the hook for the cost of the care,” the groups said.
Among other things, the governor made the following recommendations for changes to the bill:
- Require an employer to provide an injured worker or an injured worker’s medical provider with a mailing address and an electronic mailing address to which medical bills should be sent.
- Require a medical provider to submit its bill to the employer or insurer within 90 days of the date on which the services were provided to the injured worker.
- Delete language that requires the Medical Fee Advisory Board to assist the Illinois Workers’ Compensation Commission with adopting certain rules concerning requirements for the explanation of benefits.
- Permit a medical provider to file a petition with the Commission to determine if interest is owed on an undisputed medical bill (rather than permitting a medical provider to file suit against an employer or insurer for interest payments).
- Require the Director of Insurance to adopt rules concerning administrative fines for insurers that intentionally or repeatedly fail to comply with the electronic claims acceptance and response process.
- Delete language that requires the Director of Insurance to adopt certain rules concerning electronic claims, including rules that ensure that health care providers have an opportunity to comply with requests for records by employers and insurers for the authorization of the payment of workers’ compensation claims.
This article was first published by Insurance Journal.