The introduction of managed health care into Oklahoma's
workers compensation system makes House Bill 1002, which was
signed into law Friday, the strongest workers compensation reform
measure passed during David Walters's administration, the
governor has said.
Other equally ambitious provisions in the original bill, such
as a mandatory independent medical examiner system to rate all
injuries and a required safety program for businesses with more
than 25 workers, were watered down during the legislative
The bill's provisions targeted at helping injured workers
include an increase in disability benefits for workers who make
more than $400 weekly, a shortened waiting period _ from seven to
three days _ for disability benefits, and a doubling of death
Specifically, the law's provisions are:
Certified workplace medical plans for treatment of workplace
injuries and illnesses. This is a type of managed health care
plan similar to the managed care provider networks that are part
of many employees' regular health care plans. If a business
contracts with a workplace medical plan, a worker at that
business would join the plan or designate his or her own family
physician for treatment in case of a work-related injury or
If an employee chooses a family physician, all treatment by
the physician and any referrals must comply with the rules of the
workplace medical plan if the employer has such a plan. An
employer cannot fire an employee for not choosing the workplace
medical plan. Workers can change choice of physician during an
annual enrollment period.
The law also provides that self-insured employers that have
collective bargaining agreements in place must have workplace
medical plans approved by the union. At least one lawmaker has
said this provision probably will be altered during the regular
session next spring.
Certified plans will be approved by the health department and
must provide "quality services," convenient access for
participants in a geographic region, financial incentives to
reduce service costs, peer review, dispute resolution, case
management and utilization reporting. They also must provide
timely emergency authorization of medical providers not in the
plan. An approved plan cannot discriminate against any provider.
The state health commissioner will review plans for approval
and may add additional requirements.
Mandatory safety programs for the most hazardous workplaces. The
state labor commissioner must compile a list each year of the
most hazardous industries in the state and distribute that list
to every insurer that writes workers compensation insurance in
the state. The law does not specify how many industries will be
on the "most hazardous" list. The insurers must develop safety
programs for all policyholders that are on the list and that have
workplace accident or health risk experiences that are 25 percent
or more worse than other businesses in their industry. Safety
programs will also be required of policyholders with accident or
risk experiences that are twice as bad as other businesses in the
same industry category and of all self-insured employers.
Insurers must notify policyholders when they are required to
develop safety programs. Safety programs may be developed by the
insurance company, the labor department, private safety
consultants or vocational-technical schools.
In addition to the safety programs, all workers compensation
insurers must provide "safety services," including safety
training and consultations.
Equalization of premium rates among high- and low-wage employees.
The Oklahoma Property and Casualty Rates Board will devise a
method, subject to legislative review, for equalizing premiums
among high-wage and low-wage employees. Currently, employees with
high wages can only collect up to a percentage of the state's
weekly wage, although their premiums are higher. …