Council on Workers' Compensation
Meeting Minutes
GEF-1 Building
Madison, Wisconsin
January 13 , 2015
 


Members present: Mr. Beiriger, Ms. Bloomingdale, Mr. Buchen, Ms. Johnson, Mr. Kent, Mr. Metcalf, Ms. Nugent ,  Mr. Redman, Mr. Schwanda, and Ms. Seiler

Staff present: Mr. Aiello, Ms. Endter,  Mr. Ezalarab, Mr. Krueger, Mr. Moreth and Mr. O'Malley

Excused: Mr. Brand, Mr. Ginsburg, and Ms. Thomas


  1. Call to Order/Introductions: Mr. Metcalf convened the Worker's Compensation Advisory Council (WCAC) meeting at approximately 10:05 a.m. in accordance with Wisconsin's open meetings law. WCAC members, staff and members of the audience introduced themselves.

  2. Approval of minutes: Ms. Bloomingdale moved to approve the minutes of the January 23. 2014 meeting. Mr Buchen seconded the motion. The minutes were unanimously approved without correction.

  3. Correspondence: Mr. O'Malley reviewed correspondence concerning proposals for changed to ch. 102, Wis. Stats.

    A letter of November 18, 2014, from Joe Paduda, President, CompPharma, has two proposals: require physician dispensing reimbursement to be based on the original manufacturer's NDC number; and restrict medical providers from dispensing medication seven days postdate of injury.

    Joseph Hulwi, BC-HIS, sent an email message on December 30, 2014, proposing that if the statue of limitations is changed, that it be reduced to 6 years.


    A January 9, 2015, letter from Kay Morgan, VP, Drug Product & Industry Standards, ELSEVIER Gold Standard, proposed the following change to section 102.425(3)(a)1., Wis. Stats.: "The average wholesale price of the prescription drug as of the date on which the prescription drug is dispensed, as quoted in a nationally recognized pricing resource.

    A January 12, 2015, letter from Jennifer Mauer, Director of Government Affairs, Automated HealthCare Solutions, recommended that physician dispensed medications be reimbursed at a maximum of 112.5 percent of the original manufacturer's average wholesale price.



  4. Public Hearing Comments: Mr. O'Malley stated that the Public Hearing was held in Madison on December 11, 2014, with video conference hook-ups in Eau Claire, Green Bay, La Crosse, Milwaukee, and Wausau. Mr. O'Malley said that about 50 persons in total attended the public hearing, and that 12 of those made comments. Sharon Belton from the Worker's Compensation Research Institute made a presentation but did not have any specific proposals. Mr. O'Malley then directed attention to the hand-out containing a summary of the proposals from the public. He went over each proposal and the members engaged in general discussion about them. Mr. Metcalf advised the members that he can provide the members with the prior department proposals. He also informed the members that the health cost data bases had been audited and asked if the members would like to review the audit recommendations. Mr. Metcalf stated there were no new proposals from the department, from LIRC, or from the Self-Insurers Council.


  5. Work Injury Supplemental Benefit Fund [WISBF]Balance: Mr. Metcalf reminded the members that the WISBF, as of May 14, 2013, suspended reimbursements of supplemental benefits payments to permanently and totally disabled individuals, but that all other claims were being paid from the WISBF. Mr. Krueger provided a handout showing that the WISBF has a $6.2 million cash balance but with a total balance of $6.9 million after the accounts receivable of $715,000 are included. He also explained that the department is still receiving requests for supplemental benefit reimbursements but the department is holding them in abeyance. The requests for reimbursement total $7.5 million. Mr. Krueger pointed out that the WISBF balance had been down to $1.9 million but that the WISBF is now strong. Mr. Metcalf stated that the department accepts requests for supplemental benefit reimbursements made within 12 months after the year the payments were made. The department had an influx of requests once the 12 month time frame was set but that all of those were cleared out.

    Mr. Beiriger recalled that the draw down on the WISBF was a matter of urgency two years ago and asked if anything else needed to be done. Mr. Metcalf pointed out that the last agreed upon bill contained a provision for an assessment on the carriers, not the self-insurers, to pay off this liability over time. Mr. O'Malley informed the members that these claims for permanent total disability supplemental reimbursements predate January 1, 2000, there are fewer than 1,000 of these PTD claims, and that about 20 of these disabled workers die each year.   



  6. Public Proposals: This was covered in the Public Hearing Comments.

  7. Other Council Business: A room has been reserved for the Council for the second Tuesday of every month through the end of the year. While the Council traditionally meets until June or July, since the rooms are reserved for them, they can meet later in the year if they choose. Mr. Bieriger asked if it would be possible that all of the proposals are available when they start their deliberations at the February meeting. Mr. Metcalf said that two additional proposals may be coming from the Health Care Provider Advisory Committee. One is a possible proposal to add Opioid treatment language to the treatment guidelines in ch. DWD 81. The second is a letter from the members of the committee on prescription drug cost issues. A member of the Health Care Provider Advisory Committee will appear at a future Council meeting to address these proposals.

    Mr. Kent inquired as to where in the process were the rules that they had proposed over 4 years ago. Mr. O'Malley stated that the department now has an administrative rules coordinator and a hearing draft of the rules should be available for the members in the next couple of weeks.

    The members inquired as to whether there are any changes in the internal structure or organization of the division. There was nothing to pass along at this time.

    Mr. Metcalf said that the division created two senior ALJ positions: a senior ALJ for training and a senior ALJ for health cost disputes. The total number of ALJ positions remains unchanged, and the senior ALJ's will continued to hold hearing calendars. The members asked if there was a hearings backlog. Mr. O'Malley answered that we now scheduled 97 to 98 percent of the cases for hearing about 15 weeks after they are put in ready status, compared to 14 to 15 months in 2007; with about 630 - 640 cases ready to be heard. By comparison, it takes a couple of years to get a hearing in Indiana and from 6 months to several years in Illinois.

  8. Adjournment: Ms. Bloomingdale moved to adjourn. Mr Bieriger seconded the motion. Meeting adjourned at about 11:00 a.m. by unanimous approval.
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