New law will increase workers’ comp options

A new law going into effect next January will give injured workers in Colorado – for the first time – an opportunity to choose the doctor and/or occupational medicine clinic they will use to help them get back to work.

The law, House Bill 1176, says an employer must provide a list of “at least two” doctors or corporate medical providers from which injured workers can choose to treat their work-related injury. Under current law, an employer can and often does direct the injured employee to a particular doctor or clinic for care covered by workers’ compensation insurance. Some employers have been criticized for partnering with providers who cut corners or try to minimize care.

Rep. Morgan Carroll, D-Aurora, tried for three years to get a version of the Second Provider Bill through the Legislature and finally mustered the votes – and the backing from most concerned – to get it passed in the 2007 session.

“It took three years and it was a complete rewrite every year,´ said Carroll, who’s also an attorney. “The majority of states allow for injured workers to choose or change their doctor. Colorado was one of a few states not to have a free-market approach.”

Busting a ‘monopoly’

Carroll said passage of the bill marked the breaking of a “40-year monopoly” in which Colorado employers could choose to send injured workers to just one provider.

Carroll said the existing workers’ comp system lets the insurance provider choose the treatment provider, and if that provider wants to stay on the preferred provider list, its primary focus will be on saving the insurance company money.

“The conflict of interest comes up when the person who decides who gets the business or not isn’t the patient,” she said.

That sometimes led to situations where the treatment provider did little to please the patient.

“They had no reason to have a bedside manner,” she said. “The one master they had was the insurance company under the old system.”

Reaction to the new law in the local occupational medicine community has been mixed but mostly acquiescent. Amber Denzel, who co-owns Loveland Urgent Care and Greeley Quick Care, said her company has never had contracts with the employers it serves.

“One of the things we don’t ever require is contracts,” she said. “For those with contracts, I can see how that could be a problem.”

Denzel said she supports free choice. “Any type of choice is good,” she said. “If you tell someone they have to go here or there, it’s just not good health care.”

Steve Pottenger, CEO of Workwell Occupational Medicine, said his company was neutral on the bill as it made its way through the Legislature. “It’s got some positives and some negatives,” he said. “We really didn’t feel the workers’ comp system was a broken system. We didn’t hear any of our clients being dissatisfied with it.”

But Pottenger said the bill could help make all occupational medicine providers try harder. “It rewards those who can get people back to work quicker,” he said.

Less employer control

Pottenger said he thinks the new law will have the biggest impact on employers. “They’ve been able to maintain control and oversight with one provider and get a good rapport going with them,” he said. “They kind of lose that control of referring (workers) to people they know will do a great job for them.

“I think for us, the jury’s still out,” he added. “We hope there isn’t any fragmentation of health care or abuse of the system.”

Carroll said she’s represented many people with workers’ comp care complaints and predicts the new law will help reduce those kinds of cases.

“It should mean a decrease in litigation and an increase in ownership of health care because (injured workers) have a choice now,” she said, adding that getting to choose a treatment provider “gets a patient more invested in their own care.”

Carroll said the bill is still only a small step toward patient choice. She noted that employers still have the right to approve the list of providers their employees may see to get workers’ comp care.

“They still have a ton of control but now a teensy bit of free-market forces can come into play with some choice,” she said. “Now there’s a little bit of accountability in the system, when before, pleasing the patient wasn’t part of the equation.”

Pottenger said while the new law has “certainly thrown a new consideration into the mix,” he’s hopeful that it will help make the injured employee more of a player when it comes to getting back to work as soon as possible.

“Providers and employers really work together to get people back to work, and the employee is part of that team as well,” he said.

Steve Porter covers health-care issues for The Northern Colorado Business Report. He can be reached at sporter@ncbr.com or at 970-221-5400, ext. 225.

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