Chamber members get update on worker's comp
By BRENDA ALLUMS news1@kilgorenewsherald.com

House Bill 7, a Worker's Compensation Reform Bill passed during the last regular session, is a "very good thing."

That's what Ron Walenta, a member of the Texas State Office of Risk Management Board, told local employers yesterday.

Walenta was the featured speaker at a breakfast seminar sponsored by the Industrial Relations Committee of the Kilgore Chamber of Commerce and the Kilgore Economic Development Corporation (KEDC). A number of area employers attended the morning meeting to learn about the recent reforms.

Under HB 7, the Worker's Compensation Commission was abolished and functions of that commission moved under the Texas Department of Insurance (TDI). The TDI is now responsible for helping injured workers with claims and disputes.

"The dispute resolution process is streamlined by HB 7," Walenta said.

He said the dispute process is streamlined for all parties - workers as well as health care providers.

"HB 7 ensures providers are paid in a timely manner for their services," Walenta said. "The TDI is now responsible for monitoring provider networks and reviewing and approving rates charged by insurance carriers."

The legislation allows for health care networks, Preferred Provider Organizations (PPO), much like to those in group health insurance plans.

"The legislation provides for mandatory PPO networks," Walenta said. "This system will help lower the cost of worker's compensation to taxpayers while reducing the wait for medical care."

Walenta said HB 7 expedites and enhances injured employees' income benefits.

He said the PPOs would have control of treating doctors, treatment practices, referrals and billing.

"If a doctor is not in the network, then he would not be allowed to treat," Walenta said. "The effect (this legislation has) on workers compensation premiums will be a 50 percent reduction in costs."

Walenta explained that Under HB 7, a worker would select a doctor from within an adequate network panel, similar to the way doctors are chosen in group health plans.

Walenta said networks under HB 7 are tailored to meet the specific factors present in workers' compensation care. "One major difference between workers' compensation health care and group health is that workers' compensation is fully paid," he said.

Network under HB 7 are restricted to a particular set of providers that are "held to requirements that they make care available and accessible."

Walenta said several other improvements have resulted from the passage of HB 7 in addition to the networking.

"More emphasis is placed on care according to evidencebased treatment guidelines and on up-front treatment planning for out-of-network claims where necessary care may be in dispute," Walenta said.

The return to work and income benefit enhancements in the bill also apply to both network and non-network claims.

The bill also improves the operation of the agencies charged with administering the workers' compensation system. Walenta said all aspects of the bill are not in place yet.

"The bill went into effect in September, 2005, and in January, 2006, the first applications for PPOs were filed."

Walenta said 22 applications have been submitted and six have completed the process.

He estimates the bill will be fully operational by April.

"I'm looking forward to sharing the information with human resource personnel in our banks in Kilgore, Gladewater and Longview," said Carolyn Johnston of City National Bank. "I'm also looking forward to the bank saving money with workers'' compensation."

Investment broker Wilbur Yates said he "learned things he was not aware of " concerning worker's compensation.

"I'm glad I came and spent the time to learn about HB 7," said Pat Nault of Danmark Energy.