Audit finds hefty workers’ comp backlog
report backs claims of former employees fed up with inaction
State auditors found muddled chains of command, incomplete or missing files, and a massive backlog of cases when they dug into the enforcement process at the Division of Workers’ Compensation, according to a report released Thursday. The audit is ongoing, but it supports the claims of former employees who left the division this year amid complaints of stalled action on dozens of cases against physicians accused of abusing the system.
“Tens of millions of dollars of unnecessary care has been exposed and identified to the division, and they didn’t do a stinkin’ thing about it,” said Dr. Ken Ford, the division’s former assistant medical advisor. “It’s a tragedy.”
The division’s Office of the Medical Advisor identifies and investigates doctors for overtreat- ing patients, overcharging insurers or otherwise violating the rules of the state workers’ comp system.
The findings are sent on to enforcement, whose attorneys are responsible for issuing disciplinary orders or litigating the cases. In some instances, they take doctors to trial at the State Office of Administrative Hearings. But former employees and the state audit reveal that hundreds of cases are stalled or disappearing as they reach the enforcement stage.
The result, over the past half decade: Hundreds of cases in which medical quality reviewers recommended doctors for sanction or removal from the system have sat untouched or unsupervised.
According to the audit, 81 cases were never logged, more than 20 percent of cases were closed without clear documentation, and 661 enforcement cases have been open for an average of 15 months without action. One case has been open since 2006, and more than 60 cases