Workers’ Compensation Agency starts process to implement evidence-based medicine in Michigan.
The workers’ compensation section of the State Bar of Michigan has received proposed rules for the implementation of evidence-based medicine. Director, Kevin A. Elsenheimer, will start the adoption process on February 19, 2014.
Official Disability Guidelines (ODG) has been selected as the single source for the state. Treatment within these guidelines will be presumed reasonable and necessary triggering payment under the Act. Medical care outside the guidelines will not be compensable unless authorized by the director or a magistrate as part of an exception process.
Evidence-based medicine (EBM) has been causing controversy for years. It will have a significant impact on injured workers in Michigan. Here are some reasons why it is a terrible idea.
EBM restricts your choice of doctor by creating an enormous amount of unnecessary bureaucracy. Doctors will not get paid unless they adhere to specific guidelines that few people understand. The exception process will be difficult and require physicians to spend more time on paperwork than treating patients. Many doctors will simply refuse to treat people under workers’ compensation.
EBM shifts the cost of medical treatment away from the responsible employer and on to the taxpayer. Injured people don’t just go away because an arbitrary guideline says they are better. The cost of medical care will be shifted to taxpayers through Medicaid and Medicare. A greater burden will also be placed on private health insurance creating higher premiums for everyone.
EBM is the proverbial “death panel.” Bureaucrats in Lansing will be making decisions about medical care. Physicians will have almost no say in treatment as their hands will be tied. This will cause real suffering for people struggling with disability.
EBM relies upon outdated and flawed data. Research is expensive and some areas of medicine are underfunded. Certain population segments have also been historically under-researched. Doctors should be free to treat patients as individuals based upon clinical experience and knowledge.
EBM is a product offered for sale. We have serious concerns about who is profiting and funding these guidelines. Greater transparency should be required and one company should not have a monopoly.
EBM replaces a working system with a broken system. Michigan already has a fee schedule that keeps medical costs low. The Workers Compensation Research Institute (WCRI), a not-for-profit organization, found that medical payments in Michigan were typically lower than all 16 states in its 2013 study. Insurance premiums are expected to drop by an average of 8.3% in 2014. The pure premium advisory rate has already decreased more than 20% in the last three years.
EBM cannot be implemented with just a rule change. The Michigan Legislature passed significant workers’ compensation reforms in 2011 and EBM was left on the cutting room floor. This issue should be debated in the open by our elected representatives.
EBM conflicts with the Act. Workers’ compensation is social and remedial legislation. It is supposed to err on the side of approving not denying benefits. This is the grand bargain that was established when people gave up their right to a civil trial. EBM changes 100 years of law in Michigan and conflicts with the plain language in the Act.
To speak with a workers compensation attorney in Michigan, call (855) 221-2667 for a free consultation.
– Alex Berman is the founder of Michigan Workers Comp Lawyers. Hes been representing injured and disabled workers exclusively for more than 35 years. Alex has helped countless people obtain workers compensation benefits and never charges a fee to evaluate a case.
– Photo courtesy of Creative Commons, by 401(K) 2013.