Oregon Doctors Upset Over Change in Workers’ Comp Rules

Health care providers all over Oregon say they’ll have to drop workers’ compensation cases, after a change in how they are paid to care for those injured on the job.

The temporary rule, imposed July 7, 2008, allows insurance companies to pay doctors less than the state-mandated schedule of fees historically used in such cases.

Administrators with the workers’ compensation division at the Bureau of Labor and Industries have acknowledged that the new rule underwent a “fast analysis.”

But division administrator John Shilts told The Oregonian that state actuaries had warned him that without the rule, employers would see insurance premiums shoot up.

Businesses in Oregon have long enjoyed some of the nation’s lowest rates for workers’ comp coverage.

Doctors and their representatives are urging Shilts to repeal the rule, restoring the payment method that has been in place since the state reorganized its workers’ compensation system in 1991.

“You have turned the whole world upside down for physicians and providers,” said Dolores Russell, president and chief executive officer of Managed Healthcare Northwest, a state-regulated physicians’ network just for injured workers.

The new rule allows insurance companies to hunt for the lowest fee possible when paying doctors in workers’ compensation cases. Insurers can search for any contract a doctor has signed that agrees to reduce fees in exchange for getting a higher volume of patients with group health insurance.

The doctors say such discounts violate Oregon law, which says workers’ compensation is a separate operation with separate fee schedules that insurers must abide by.

Injured-worker cases demand more attention to patient and paperwork, and doctors say they are stretched as it is to cover the higher costs.