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03/03/2010

OSCA Meets with BWC

Drs. Jeff Zaika, Dick Thompson, Otto Schmidt and Jud Sprandel along with OSCA lobbyist David Leland met on February 18 with the BWC administrator and the BWC chief operating officer in Columbus. The group discussed in detail:

  • the misuse of Mercy/ODG (Official Disability Guidelines),
  • addressing the MCO use of predictably negative reviewers and
  • management and treatment of chronic cases.

On February 23, Drs. Jeff Zaika and Otto Schmidt met with the director of the Ohio Department of Administrative Services (DAS) along with OSCA lobbyist David Leland to discuss WILMAPC. In attendance were also 3 other staff members from DAS.

As you may recall, WILMAPC is the partnership between state employees and 4 Ohio labor unions. The WILMAPC committee and union representatives view WILMAPC as an opportunity to steer their injured workers to data-driven providers. There are 3 MCOs that deal with the state agencies: CareWorks, CompManagement and University Management. (See OSCA E-News dates 12/18/09 for more information.)

After much dialogue, the DAS staff acknowledged that this is a working project. They noted that they implemented an appeal process due to the questioning from the OSCA at the open forum weeks prior. OSCA representatives requested that the OSCA be involved in the appeal panel as well as the collection and interpretation of data to determine if the DC will be invited back to the panel. They agreed to our request.

We further expressed our concern regarding the use of ODG as a basis for their data. The director is open to looking at additional guidelines.

They stated that their reasons for developing WILMAPC were as follows:

  • to reduce insurance costs (if worker is off work, they continue to pay 100% of the premium),
  • Return To Work (RTW) savings of BWC cost,
  • anticipate little impact on DC panels (everyone is invited) and
  • they are not looking to control the DC.

Our lobbyist will continue to monitor development and follow up with the OSCA as the system unfolds. Our thanks go out to OSCA lobbyist David Leland for arranging these meetings.