Physicians, WMC Clash over Worker’s Compensation Proposal

Physicians and a key business group are clashing over a new workers’ compensation proposal that would significantly change how doctors are paid.

Wisconsin Manufacturers & Commerce says companies get overcharged by providers and hospitals for medical expenses to treat their injured employees — and that adding a fee schedule for medical procedures like most other states would keep costs down.

“It’s something that employers have long sought, to bring some relief to the equation when it comes to medical bills within workers’ comp,” said Chris Reader, WMC’s director of health and human resources policy.

But the Wisconsin Medical Society says the current system leads to better patient outcomes and satisfaction, improved access to doctors, lower rates of lawsuits and injured workers getting back to their companies sooner.

“There’s no evidence that such a scheme is necessary in the first place,” said Mark Grapentine, the senior vice president of government and legal affairs at the Wisconsin Medical Society. “By just about every metric that folks care about, the Wisconsin workers’ comp system is one of the best in the country.”

The fight isn’t new. The two sides battled over the issue two sessions ago, when WMC’s effort to add a fee schedule to the system failed.

The venue — until now — has been the Worker’s Compensation Advisory Council, made up of five labor representatives, five management representatives, three non-voting insurance representatives and one representative from the Department of Workforce Development. The health care community also has four liaisons who advise the council.

The council on Wednesday, after two days of meetings, reached an agreement between labor and management that would, among other things, add the fee schedule that WMC supports and meet a key labor priority of boosting disability benefit rates.

That agreement is now being drafted as a bill and will head to the Legislature, which in 2014 rejected a proposal from the council for the first time in decades, largely over the fee schedule provision.

Reader, of WMC, predicted that lawmakers would approve the measure this session because they have more time to review it and there aren’t other controversial elements of the bill.

But Grapentine, of the Medical Society, said lawmakers rejected the idea last time because “all of the facts and data” show that Wisconsin’s system is working. Eric Borgerding, the president and CEO of the Wisconsin Hospital Association, made a similar pitch.

“Here we are, once again, talking about fee schedules and price setting; outdated solutions looking for a problem,” he said in a statement. “It’s really time to move on.”

Stephanie Bloomingdale, secretary-treasurer of the Wisconsin AFL-CIO, said in a statement the union backs the “agreed-upon bill that was arrived at through the long-established” process of the council.