5304-S2.E AMH CAMP H2497.1

E2SSB 5304 - H AMD TO REV COMM AMD (H-2235.7/93)  000366 ADOPTED 4-8-93

By Representatives Campbell and others

    Beginning on page 167, line 1 of the amendment, strike all of sections 474 and 475 and insert the following:

    "NEW SECTION. Sec. 474.  WORKERS' COMPENSATION MEDICAL BENEFITS.  On or before December 1, 1994, the health services commission, in coordination with the department of labor and industries and the workers' compensation advisory committee, shall complete a study related to the medical services component of the workers' compensation program of the department of labor and industries.  The goal of the study is to determine whether and how the medical services component of the workers' compensation program can be modified to provide appropriate medical services to injured workers in a more cost-effective manner.  In conducting the study, consideration shall be given to at least the following factors:  Workers' choice of health care providers, twenty-four hour coverage, the relationship between rehabilitation and medical services, and the quasi-judicial system that overlays treatment.  The study shall evaluate at least the following options:

    (1) Whether the medical services component of the workers' compensation program should be maintained within the department of labor and industries, and its purchasing and other practices modified to control costs and increase efficacy of health services provided to injured workers;

    (2) Whether the medical services component of the workers' compensation program should be administered by the health care authority as the state health services purchasing agent, pursuant to section 225 of this act.  Any recommendation proposing that the state health services agent purchase injured workers' medical services shall assure that the uniform benefits package will provide benefits that are medically necessary under the workers' compensation program in 1993, including payment for medical determinations of disability under Title 51 RCW, and consider issues presented by twenty-four hour coverage and the use of managed care to provide medical services to injured workers;

    (3) Whether the medical services component of the workers' compensation program should be included in the services offered by certified health plans through employer sponsorship as provided in chapter . . ., Laws of 1993 (this act).  Any recommendation proposing the inclusion of workers' compensation medical services in the services offered by certified health plans shall assure that (a) no less than ninety-seven percent of state residents have access to the uniform benefits package as required in chapter . . ., Laws of 1993 (this act), (b) the uniform benefits package provides benefits that are medically necessary under the workers' compensation program in 1993, including payment for medical determinations of disability under Title 51 RCW, (c) time-loss benefits and rehabilitative services will not be reduced as a result of the transfer, and (d) the employees' share of the workers' compensation medical aid fund contribution will be returned to employees as increased wages."

    Renumber the remaining sections consecutively and correct internal references accordingly.

EFFECT:  Modifies workers' compensation section to include medical and program in the uniform benefits package.  Inserts related studies.

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