PCI CALLS FOR TWCC REFORMS:

Testifying before the Texas Sunset Advisory Commission, the Property Casualty Insurers Association of America (PCI) asserted that substantial changes are needed to address problems with the Texas Workers’ Compensation Commission (TWCC). PCI expressed concerns with the overall system, including the high cost of workers’ comp coverage, rising medical costs and utilization, limited access to quality medical care, and poor return to work outcomes for injured workers. These issues were also highlighted in the Sunset Commission Staff Report released in April. Regarding the governance and structure of the commission, PCI recommends that the administration of the Workers’ Compensation Act should be separate and independent from the administration of the insurance code. All the workers’ compensation commissioners should serve full time and thus be less dependent on staff for information and guidance. The commissioners should appoint a staff executive director to run the day-to-day operations. PCI believes that the research on the effectiveness of the workers’ compensation system needs to be independent of TWCC and for that matter the department of insurance. PCI said that over the past few years, the biggest problem with the Texas workers’ comp system has been abuses in the delivery of medical care that has resulted in the highest medical cost per injury and one of the worst return-to-work outcomes in the United States. “We urge that a medical network system of care in workers’ compensation be placed with insurance carriers, because insurers are more experienced and successful in delivering medical benefits in a cost-efficient manner and with good return-to-work outcomes. TWCC has spent far too much time and focus over-regulating this process. Its handling of compliance monitoring and sanctions appears to be grossly out of balance and has not addressed the current abusive billing practices of some healthcare providers,” stated Joe Woods, regional manager and assistant vice president for PCI.