Checking in on New York After 2007 Reforms

NYCA new report done by WCRI is checking on the performance of the New York workers compensation system since the implementation of the 2007 reforms, to see how the metrics have changed and improved.

These follow ups help lawmakers and stakeholders make adjustments or focus more attention on areas that are not up to par and meeting the necessary objectives, so that further reforms are not needed and there are no legal consequences to be had.

It will still take many years to fully see the true implications of all the reforms and to make sure they are all performing accordingly as there were various implementation dates where these were rolled out.

The major reforms of 2007 were:

  • to increase the maximum weekly benefit;
  • to put caps on permanent partial disability duration;
  • the creation and implementation of medical treatment guidelines;
  • implementing a pharmacy fee schedule;
  • creating diagnostic networks for services while putting thresholds on preauthorizations; and
  • changes in administration to increase the speed of cases being closed

Some of the key findings that WCRI acknowledges:

  • The average weekly temporary total disability payment increased by 26% after the reform implementation which was done in three increases in the rate between 07-09.
  • Depending of the drug and the dosage with the implementation of the pharmacy fee schedule NY was able to drop the price per pill by 10-20 percent.
  • PPD cases with no lump sum payments fell by 13% from 07-09 even though there was a 10.5% in cases involving lump sum payments but no PPD.
  • Cases involving defense attorneys increased from 05-07 then leveled out between 07-09.  It increased by 2% in 2010 due to cases involving defense attorneys with payments of $500 or less.

WCRI conducted this study using open and closed indemnity and medical only claims on injured workers from 10/04-09/10 with experience up to 3/11.  This report and all data involved represented the New York workers comp system.

This is a great follow up done up WCRI, New York took the initiative to see where their workers comp system was having issues and enacted reforms to help make the system better.  There is still room for improvement, but judging by these stats they have made some improvement in the right direction.  One would have thought that by increasing the weekly benefit you would have less fraud because the injured worker was being compensated better however as we previously reported here on WCInsights New York is now second in the nation for questionable claims, I guess people figure since they are giving more money out they would try fraud now.  I applaud New York for making changes to benefit the injured worker and move their system in the right direction.

Source: WCRI

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