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NCCI – Work comp legislative and regulatory trends

The last session on Thursday focused on regulatory and legislative trends  – primarily focused on state issues.  There’s also a session on the impact of ACA on work comp; that’s something I’ve spent far too much time on – that and the fact that lead speaker Mark Walls just looks fabulous after his make-up session in the green room has me in the reg/leg session.

Mark did spend a bit of time on ACA, citing concerns and issues including that unicorn of workers’ comp; the oft-described but never adequately documented “Monday morning injuries”; that employers are increasing deductibles and copays as a result of ACA; that he doesn’t believe that people with insurance are healthier than those without; and that a lot of people still aren’t covered.

Much as I like Mark, I have to disagree with him on most of these issues.  For reasons why, see here, here, and here.

Mark also touched on issues as diverse as unionization among Division 1 athletes, medical marijuana, opt out, and the potential need to change the basis for premium calculation from payroll basis to risk class.

He made a pretty compelling case for consideration of the latter, noting that this would reflect the changing way many employees are compensated and not penalize companies for seeking to pay higher performers more – and differently.

Lori Lovgren and Ann Bok followed Mark with the top five issues in work comp.

One of the more interesting is their work in estimating the potential impact of regulatory or legislative changes on work comp premium rates.  They get these requests from a variety of stakeholders in many states; an example was their estimate that eliminating physician dispensing up charges in FL would reduce costs by about a percentage point.

Don’t expect to see much in the way of legislated change this year as it is an election year, and elected reps won’t want to upset constituents while they are campaigning. That said, the potential issues NCCI is seeing include:

  • changes to reimbursement and fee schedules
  • medical cost containment e.g. employee choice of physician
  • benefit changes
  • claims administration issues

Among the rate changes coming are several rather significant ones:

  • Missouri – 11.6% increase
  • Hawaii – 6.2% increase
  • Virginia – 4.1% increase
  • Oklahoma – 14.6% decrease
  • West Virginia – 8.9% decrease
  • SD, KY, ME, and IN – decreases around 8%


One thought on “NCCI – Work comp legislative and regulatory trends”

  1. thanks for a good post Joe. It will be interesting to see how the shortage of providers will have an affect on both WC and general health when the 30+ million people are on the rolls and if the lack of wage replacement in general health will balance any benefits to comp that Obamacare is supposed to have on the system. I like Mark too!

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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