The Sunset Advisory Commission would like your help in reviewing and improving the way Texas regulates workers’ compensation. The Legislature, through the Texas Sunset Act, has charged our Commission with reviewing the mission and performance of both the Division of Workers’ Compensation of the Texas Department of Insurance and the Office of Injured Employee Counsel.
In general, the Sunset Commission periodically evaluates state agencies to determine if the agency is needed, if it is operating effectively, and if state funds are well spent. Based on the recommendations of the Sunset Commission, the Texas Legislature ultimately decides whether an agency continues to operate into the future. Additional information on the Sunset Commission can be found on our website at www.sunset.state.tx.us.
As part of these agencies’ reviews, we seek the input of organizations and individuals who have an interest in the agencies. Please take some time to comment on the attached questionnaires that include issues identified by the Sunset Commission staff as potential research areas. Also, let us know of other issues of interest to you or your organization. Feel free to share copies of this email and the attachments with any others who may have an interest in the Division of Workers’ Compensation or the Office of Injured Employee Counsel. To help ensure the free flow of information, comments submitted to Sunset staff before publication of the staff report are confidential.
To give the staff time to consider your information during our review of the Division of Workers’ Compensation and the Office of Injured Employee Counsel, we request you send your response by January 8, 2010. Please mail, email, or fax your comments to the address or fax number provided on the attached Questionnaires. Also, if you need more information or have questions about our process, please contact Chloe Lieberknecht at (512) 463-1300. We greatly appreciate your assistance and look forward to hearing your ideas.
1.Has
the transfer of workers’ compensation functions from an independent agency to a
division within the Texas Department of Insurance (TDI) worked well?Is having the Division of Workers’
Compensation part of TDI effective?
2.Has
the workers’ compensation system improved since legislative reforms from 2005
have taken effect?If so, how?If not, why?What improvements still need to be made?
3.Is
the Division’s regulation of the workers’ compensation system at the
appropriate level or does regulation need to be strengthened or reduced?Is the system fair to all participants?
4.Is
the Division adequately soliciting stakeholder input in developing guidelines,
rules, and polices?
5.Is
the Division effectively communicating information and educating system
participants about the workers compensation system?
6.From
your perspective, has the transition to certified workers’ compensation
networks improved the workers’ compensation system?What changes, if any, need to be made to make the network
system work better?
7.Are
designated doctors providing an objective and meaningful evaluation of injured
employee cases?
8.How
are the dispute resolution processes administered by the Division working? Are
the processes accessible, timely, straightforward, and consistent?
9.How
effective are the Division’s enforcement functions?Are the processes just, fair, and consistent?
10.Please
add any other comments about the Division of Workers’ Compensation. If you
would like to suggest any changes to the Division, its operations, or its
statute, please provide:
•a
brief statement of the suggested change,
•background
information on how the current system works and a description of what you would
like to see changed,
•benefits
of your recommendation, and
•any
potential difficulties that may arise from implementing your recommendation.
1.Is
it more or less effective to have the role of advocate for injured employees placed
in an agency that is independent from the Division of Workers' Compensation?Should the Office of Injured Employee
Counsel's functions continue in a stand-alone agency?
2.What
changes, if any, should be made to the mission and functions of the Office of
Injured Employee Counsel?
3.Does
the Office effectively communicate information regarding the workers'
compensation system and the Office's services to injured employees?
4.Does
having both the Division of Workers' Compensation and the Office involved in
providing education to injured employees create any problems?
5.Is
the Office effectively assisting injured employees in resolving disputes before
the Division of Workers' Compensation, including in Benefit Review Conferences
and Contested Case Hearings?
6.Is
the Office effectively and appropriately advocating for injured employees as a
class in judicial proceedings?
7.Please
add any other comments about the Office of Injured Employee Counsel. If you
would like to suggest any changes to the Office, its operations, or its statute,
please provide:
•a
brief statement of the suggested change,
•background
information on how the current system works and a description of what you would
like to see changed,
•benefits
of your recommendation, and
•any
potential difficulties that may arise from implementing your recommendation.
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Working-age adults who use two or more prescription medications may be at
risk for becoming seriously injured after falling in the home,
researchers found.
In a study of young and middle-age adults,
using at least two medications was associated with an increased
likelihood of dying from or being hospitalized for a falling injury ….
Antihypertensives and cholesterol-lowering drugs were the most common
medications involved.
"The risk
of falls may be increased as a result of both the intentional and
unintentional effects of pharmacological therapy such as orthostatic
hypotension, psychomotor impairment, extra-pyramidal symptoms, and
dizziness."
Overuse of therapeutic procedures, diagnostic tests, and medications is
an understudied problem that may account for as much as 30% of
healthcare spending in the United States and result in harm to patients.
The 4 most common health services examined in the studies included in the
review were antibiotics for upper respiratory infections, coronary
angiography, carotid endarterectomy, and coronary artery bypass grafting
and revascularization.
Ratings agency Standard & Poor's warned it may downgrade "a
number of highly rated" Group of 20 countries from 2015 if their
governments fail to enact reforms to curb rising healthcare spending and
other costs related to ageing populations.
"If governments do not change their social protection systems, they will likely become unsustainable."
"If no reforms are adopted, healthcare-related credit
downgrades would likely start within three years..."
"... developed nations will eventually become the victims of their
social safety nets."
"S&P said it was not too late for G20 countries to
tackle the problem, but reforms to contain age-related spending needed
be coupled with efforts to balance budgets by 2016, which would be
enough to offset rising healthcare costs by 2050."
ACA needs your help! Over the course of the past several years, ACA has been examining the
practices of chiropractic networks. Recently, concerns about these
networks has increased dramatically to the point of additional
investigative efforts being put forth by ACA.
In order to
effectively capture the voice of DCs regarding these issues, a
questionnaire has been developed to give both members and non-members
the opportunity to share their experiences about chiropractic networks.
Responding to this questionnaire will help ACA understand the effects
these networks have on profession, and will also help the association
better position itself for future efforts.
Concussions are getting much-needed attention in the press, especially
given the short- and long-term cognitive loss, early-onset dementia,
physical disability and even death resulting from traumatic brain injury
(TBI).
This study suggests that the addition of an adjunct therapeutic mirthful
laughter Rx (a potential modulator of positive mood state) to standard
diabetes care may lower stress and inflammatory response and increase
“good” cholesterol levels.
The authors conclude that mirthful laughter
may thus lower the risk of cardiovascular disease associated with
diabetes mellitus and metabolic syndrome.
An FDA proposal to require dietary supplement manufacturers to submit
data proving their product is safe doesn't go far enough, according to a
physician writing in the New England Journal of Medicine.
A survey has suggested that most dentists tend to overprescribe
antibiotics in children. The study found that adherence to
professional prescribing guidelines ranged from 10% to 42%.
US dentists write between 200 million and 300 million antibiotic
prescriptions each year, accounting for about 10% of all such
prescriptions in the United States.
The Centers for Medicare and Medicaid Services (CMS) recently ruled that
providers not successfully/satisfactorily participating in PQRS by the
2013 reporting period (Jan. 1 - Dec. 31, 2013), will have their Medicare
reimbursement decreased by 1.5 percent beginning in 2015, and 2 percent
in 2016.
Therefore, the 2012 reporting period is the last opportunity
providers have to voluntarily participate in PQRS and learn how to
report successfully/satisfactorily while incentives are still offered
and their Medicare reimbursement is not subject to penalties.
The federal government on Friday refused to let Texas ease a requirement
that health insurers devote at least 80 percent of premium revenue to
medical care.
Officials of the U.S. Department of Health and Human Services said Texas
insurance regulators did not convincingly back up their claim that
immediate enforcement of the medical-spending minimums would disrupt the
state's "individual market."
Health reform will increase the number of uninsured adults with diabetes
who will be covered by Medicaid, researchers found. That will expand
access and increase the use of healthcare in a population that has many
unmet healthcare needs.
In 2010, Medicaid covered about 60 million Americans, and in 2014 that
figure will expand by about 16 million as more uninsured patients become
eligible for the program as a result of the Affordable Care Act; about a
million of these patients will have diabetes.
Sen. Charles Grassley (R-Iowa) has demanded that 33 states and the
District of Columbia explain what they plan to do about physicians who
hand out huge numbers of painkiller and psychiatric drug prescriptions
paid for by Medicaid.
Each of the letters said, "I have concerns about the oversight and
enforcement of Medicaid abuse in your state. ... the numbers
themselves are quite shocking. One ... doctor, for
example, had written 18,890 scrips for quetiapine (Seroquel) in 2009 --
'nearly 73 prescriptions per weekday or nine prescriptions per hour .... [another] physician who had
written 2,522 scrips for oxycodone (OxyContin) in 2009, and another with
more than 2,800 prescriptions for alprazolam (Xanax)."
Some of Grassley's letters highlighted a single Wyoming
doctor who wrote prescriptions for aripiprazole (Abilify) that cost the
state nearly $300,000.
The Surgeon General's Division of the Civilian Medical Reserve Corps
(MRC) is looking for doctors of chiropractic who want to make a
meaningful contribution to America's health structure and their
community.
The Indian Health Service (IHS), an agency of the U.S. Department of
Health and Human Services (HHS), issued a public notice Monday in the
Federal Register that details the requirements for qualified health
professionals who may apply for funds available under the student loan
repayment program of IHS.
DCs are now
eligible to apply through this program.
Parker Seminars awarded some of the most influential leaders in the
profession during 2012 Parker Seminars Las Vegas. Erchonia Medical, a
leader in low level laser health care applications, was honored with the
coveted Philanthropy Award.
The Parker Lifetime Achievement Award was presented to Dr. Terry Yochum
for enhancing the profession with his substantial contributions. Dr.
Yochum, director of Rocky Mountain Chiropractic Radiological Center in
Denver, Colorado, and adjunct professor of radiology at Southern
California University of Health Sciences, is well-known for his work in
radiology.
The World Congress of Women Chiropractors (WCWC) named Dr. Janette
Kurban as the Woman Chiropractor of the Year for her exemplary service
to the profession. A 2009, Parker graduate, Dr. Kurban is actively
involved in the profession and is a leader in chiropractic. She
maintains a practice in Arlington, Texas. In 2008, Dr. Kurban made
history as the first Parker graduate appointed to serve on the Board of
Chiropractic Examiners (TBCE).
More than 5,300 Parker Seminar attendees flocked to the fresh and
exciting line-up of courses designed to improve chiropractors,
chiropractic assistants, and chiropractic students.
Texas Chiropractic College is honored to announce that Dr. Howard
Wasdin, best-selling co-author of his memoir SEAL Team Six and
practicing chiropractor from Georgia, will be speaking at the College’s
Russell Auditorium on Wednesday, Feb. 8, 2012 at 11 a.m.
Texas Department of Insurance, Division of Workers’ Compensation
(TDI-DWC) solicited and received input from workers’ compensation system
participants. All comments were carefully considered and discussed. The
Commissioner of Workers’ Compensation Rod Bordelon approved the revised
CY (Calendar Year) 2012 Annual Audit Plan (Annual Plan) on January 11,
2012.
The TBCE has passed a new fee structure in order to comply with recently passed laws. The currently proposed rule raises fees for initial applications, jurisprudence exams, initial license, and license and facility renewal and reinstatement.
The TBCE would add the definition that "on-call means that the licensee
must be available for consultation within 15 minutes either in person or
by other means of telecommunication" for the provision of any or all treatment provided under the licensee direction.
At this point in the history of mankind, we have been conditioned to
abhor symptoms of any kind. Headaches, sneezing, coughing, colds,
allergies, pain, infections, hypertension, etc., are no longer tolerated
as a part of the process of living. Rather than look into the
mechanisms that may be causing these symptoms, we are reaching for the
medicine that will suppress them. In so doing, we may feel better, but
we now have no motive to look at causes and correct for the issues that
may be impairing our health, thus increasing our "need" for more
medications over time.
Without the
"gold standard" double blind, placebo controlled study there can be no FDA approval of a new drug. So let's look at this approval process more closely.
In years gone by, many children were afflicted with polio, measles,
mumps, Rubella, influenza, small pox, diphtheria, whooping cough and
others. Of course, the majority of these children recovered without
incident (other than polio, which caused permanent nerve damage most of
the time), but there were some children who had serious sequelae and
even some who died from these diseases. Modern science discovered a way
to confer immunity on these children so that they would never become
afflicted with these diseases, and for the most part, it has been
successful. The question is, at what price?"
The Centers for Medicare and Medicaid Services (CMS) recently ruled that
providers not successfully/satisfactorily participating in PQRS by the
2013 reporting period (Jan. 1 - Dec. 31, 2013), will have their Medicare
reimbursement decreased by 1.5 percent beginning in 2015, and 2 percent
in 2016.
Therefore, the 2012 reporting period is the last opportunity
providers have to voluntarily participate in PQRS and learn how to
report successfully/satisfactorily while incentives are still offered
and their Medicare reimbursement is not subject to penalties.
ACA needs your help! Over the course of the past several years, ACA has been examining the
practices of chiropractic networks. Recently, concerns about these
networks has increased dramatically to the point of additional
investigative efforts being put forth by ACA.
In order to
effectively capture the voice of DCs regarding these issues, a
questionnaire has been developed to give both members and non-members
the opportunity to share their experiences about chiropractic networks.
Responding to this questionnaire will help ACA understand the effects
these networks have on profession, and will also help the association
better position itself for future efforts.
Concussions are getting much-needed attention in the press, especially
given the short- and long-term cognitive loss, early-onset dementia,
physical disability and even death resulting from traumatic brain injury
(TBI).
Smokers are no more likely to give up cigarettes for good by using
nicotine replacement products such as patches and gum than if they did
not use those quit-smoking aids, a prospective cohort study showed.
Working-age adults who use two or more prescription medications may be at
risk for becoming seriously injured after falling in the home,
researchers found.
In a study of young and middle-age adults,
using at least two medications was associated with an increased
likelihood of dying from or being hospitalized for a falling injury ….
Antihypertensives and cholesterol-lowering drugs were the most common
medications involved.
"The risk
of falls may be increased as a result of both the intentional and
unintentional effects of pharmacological therapy such as orthostatic
hypotension, psychomotor impairment, extra-pyramidal symptoms, and
dizziness."
This study suggests that the addition of an adjunct therapeutic mirthful
laughter Rx (a potential modulator of positive mood state) to standard
diabetes care may lower stress and inflammatory response and increase
“good” cholesterol levels.
The authors conclude that mirthful laughter
may thus lower the risk of cardiovascular disease associated with
diabetes mellitus and metabolic syndrome.
Copyright 2010 Texas Journal of Chiropractic. All Rights Reserved: Texas Chiropractic Association
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