"Strengthening Federal Workers' Compensation Programs: Ensuring Integrity, Efficiency, and Access"
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House Education and Workforce Subcommittee on Workforce Protections U.S. House of Representatives
Follow its sittingsSpeaker 2
Members on both sides of the aisle have recognized that supporting injured federal workers is not partisan. It is a matter of fairness and respect for the public service. That partisan spirit from legislation such as the Improving Access for Workers' Compensation for Injured Federal Workers' Act must continue. One guiding principle that I suggest is, how do these reforms help the workers? Any discussion about changing workers' compensation must start by centering the rights and livelihoods of American workers.
Since the cost of workers' compensation is often a direct result of an unsafe workplace, workers and their families should not be required to bear more cost in the name of efficiency. Reforms should improve efficiency, ensure timely care, and support workers' recovery and return to work whenever possible. But they must never come at the expense of the core promise that Fika was created to uphold. Most importantly, the voices of workers and their families must remain part of this conversation. The decisions made here affect real people dealing with pain, lost income, and uncertainty about their future.
Keeping their experiences at the center will help ensure that any reform strengthens, not undermines, their life-saving these life-saving programs. I look forward to hearing from our witnesses about FECA. It's working in practice and how Congress can censure it to continue to serve the federal workforce effectively. Thank you, and I yield back.
Speaker 1
Thank you. Pursuant to committee rule eight c, all members who wish to insert written statements into the record may do so by submitting them to the committee clerk electronically in Microsoft Word format by 5PM 14 days after this hearing. And without objection, the hearing record will remain open for 14 days to allow such statements and other extraneous material noted during the hearing to be submitted for the official hearing record. I note that some of our colleagues who are not permanent members of this subcommittee may be waving on for the purpose of today's hearing. Next, we're gonna go to the introduction of witnesses, and our first witness is Mr. Robert Johnson, the president of Sedgwick Government Solutions in Bethesda, Maryland.
Our second witness is Miss Stephanie McLeod, administrator and CEO at the Ohio Bureau of Workers' Compensation Programs in Columbus, Ohio. Our third witness is Mister Christopher Godfrey, the director of research at the Workers' Injury Law and Advocacy Group in Washington, DC. And our final witness is Mr. Patrick Howe, an executive vice president at Nuclear Care Partners in Grand Junction, Colorado. We're going to go to each of you individually, and I'd like to thank all of you for being here today. We look forward to each of your testimonies, pursuant to committee rules.
I will ask that each of you limit your oral testimony to a three-minute summary of the written statement which you've provided. As committee members may have many questions, the clock will count down from 3 minutes. Pursuant to committee rule eight d and committee practice, however, we will not cut off testimony until you reach the 5 minute mark. I'd like to remind each of the witnesses to be aware of their responsibility to provide accurate information to the subcommittee. And with that, I will recognize our first witness today, Mr. Johnson.
You are recognized for your testimony.
Speaker 3
Thank you, Chairman McKenzie. Thank you, Chairman Wahlberg, ranking member Omar, ranking member Scott, members of the subcommittee. Very pleased to be here today, and appreciate the opportunity to meet with you. Organizations like mine, we agree. We have a huge responsibility in the marketplace and in the workplace in the United States.
We take care of literally millions of injured workers in a given year. We have, at any one point in time, thousands of people calling us day in and day out, making contact with us who are in a time of need. They've been injured at work. They are worried about what's going to go on. They are confused by a system with lots of rules.
They have a lot of them are afraid, frankly, about what the future may hold. And when they call us, we have to take that responsibility very seriously, and we do. We have an organization of folks that are caring day in and day out. Our motto is carrying counts, actually. That's the way we go about our business.
And they depend on us. They depend on us to explain to them what's gonna happen in two days, in two weeks, in two months, because a lot of this is so foreign to them. They want us to help them get the best medical care that they can get. They want us to help them recover their lost wages. They want us to help them repair their body and injury.
They want ultimately for us to help them return to work. And they also want us to help them address, on often occasion, mental anguish because a lot of times the toll that a workplace injury takes affects a person's mental faculties as well. So that's always something that's in the back of our mind and something that needs to be addressed and cared for. We're concerned that the latest and best practices in the industry have not had an opportunity to flow completely through the federal workers' compensation system. So the things that we've been doing so successfully for over five decades and particularly some of the new technological advances that have happened in the last several years, we're concerned that those don't have an opportunity to help federal workers in the same way as those workers that we help and care for in the private sector and the public sector, day in and day out.
So we want to talk about that, and certainly answer any questions that we can. The tech that we will talk about, we believe is gonna help in better communication with injured workers, better medical care for injured workers, better accuracy and coverage of lost wages, better coordination with external stakeholders, and also better controls of fraud, waste, and abuse. We believe that costs are best controlled by the best care, and that's the bottom line. If we can get somebody better, well, and ultimately return them to productivity and to the workplace, that is what most people, the vast majority of people that have workers' compensation injuries want to have occur in the course of their transactions with us. So we believe the best care processes and the best use of technology can coexist to provide for the best for the three main parties: the injured worker, the employing agency, and, ultimately, a fiscally conscious taxpayer.
Thank you. With that, I'll yield back.
Speaker 4
Good morning, Chair Mackenzie, Vice Chair Mesmer, Ranking Member Omar, and members of the Workforce Protection Committee. My name is Stephanie McLeod. I'm the CEO and administrator of the Bureau of Workers' Compensation in Ohio, the heart of it all. We are responsible for the prevention and treatment of workplace injuries for roughly 6,000,000 Ohioans. We have about 250,000 employers in the state of Ohio that we work with.
We have about 78,000 new claims each year, and we're currently managing a little less than 200,000 active claims at any given time. I'm proud to be here today to provide testimony on BWC's operation and our history of outsourcing medical management and return to work services to injured workers to managed care organizations or MCOs. These managed care organizations are a little bit different than what your commonplace MCO may be. A lot of people think of managed care and that they're actually providing the care, that they are the providers. That is not the case in Ohio.
Our managed care organizations begin working as soon as the injury occurs, but they help file and manage the medical portion of the workers' compensation claim. They ensure the injured workers receive quality care and help get employees safely back to work after an injury. Prior to managed care, dealing with Ohio's workers' compensation program was very difficult and not very helpful. At that time, it was then governor Vojnovich and then lieutenant governor DeWine. Some of you may recognize that name from former representative Dewine, former senator Dewine, former senator Vojnovich.
But we were referred to as the silent killer of jobs. The program did not run well, not for the employer, not for the injured worker, not for the state. Now we are considered the envy of a lot of other states. We've reduced employer premiums to their lowest in 65 years, and we rank in the top five for lowest premiums in the country for our employers. This, of course, is due to multiple factors, including the culture of workplace safety, employers utilizing BWC services and offerings, the work we've done with managed care, and statewide industry changes.
We've seen a lot of changes in our workers' compensation dealing since dealing with managed care. For instance, the average time for filing a workers' compensation claim before managed care was about 65 days, and termination within the first two weeks was about 1 percent. If you understand workers' comp, you understand this is not good statistics. Now on average, it takes about 17 days from the time an incident occurs until it's filed with us, and nearly 46% of the time, we're making claim determinations within two weeks. The result and the change of the managed care program now named HPP was initiated on 03/01/1997.
I've attached for you my written testimony, the agreement between all of the parties that came to the table to summarize and to agree on HPP, the health partnership program. It's about nine pages. You will see four of those pages are signatures. That is the number of stakeholders brought together to design this system, to agree on this system, and to understand the system better. HPP applied two foundational principles to Ohio workers' compensation.
We would now contract with medical management specialists to manage injured workers' medical claims and partner with MCOs to apply best-in-class private sector concepts to our operations, such as injury reporting, medical management, and return to work services. We've also done, we had some issues. If you think about it, we reduction in workforce at that time. When we outsourced our managed care, we had a reduction in the workforce. We were about 4,200 employees at the time.
And as, in the history of my long resume, which you have before you, I was actually at the bureau as we were outsourcing. We worked with the employees to reassign them. We also engaged in a, pardon me, in a buyout, a pension buyout, where we bought out many years of their pension so that they could retire early. That created a wave of hiring, actually. So we didn't have people displaced for layoffs.
We created a wave of hiring. And if you've done the math in your head, that's about 30 some years ago. So right now, we're experiencing a lot of retirements, which is a good thing for those folks, not a great thing for us as we see experience go out the door. So we have been doing a lot of hiring, of course, and in the meantime, trying to use AI to fill that gap. And I'm happy to answer more questions about that if you have any.
Thank you.
Speaker 5
Thank you. Good morning, Chairman Mackenzie, Ranking Member Omar, members of the committee. Good morning, Chairman McKenzie, Ranking Member Omar, and members of the committee. Thank you for the opportunity to testify today regarding the federal workers' compensation programs administered by the Department of Labor's Office of Workers' Compensation Programs. I've been employed in workers' compensation programs since 1998, representing injured workers, employers, insurers, and self-insured entities.
I've also served in the public service roles at the state, local, and federal levels, including the Iowa workers' compensation commission, chief judge of the employees' compensation appeals board, and the director of the office of workers' compensation programs at the Department of Labor. In addition, I've served on the executive board of the International Association of Industrial Accident Boards and Commissions, where I've had the opportunity to serve alongside commissioners and system leaders from across all of the United States jurisdictions and from other jurisdictions in Canada, Europe, Australia, and Southeast Asia. Workers' compensation is built on the grand bargain. Workers gave up the right to sue for civil damages in exchange for prompt and adequate compensation delivered through an administrative system, and the important words there are prompt and adequate. That balance has largely sustained the system for more than a century. It should guide any changes that Congress considers.
A particularly urgent matter right now in the federal system is access to medical care. The FECA program, and its statute explicitly protects an injured worker's right to choose their own physician, and that's a principle which is born in American values of people being allowed to choose their own doctor. But in practice, the federal workers are finding it very difficult to find doctors who are willing to participate in the program. But the problem isn't the statute. It's the administrative burden surrounding medical authorization, billing, and reimbursement.
And it's a problem that's the direct result of outsourcing core federal program functions to a private contractor. And it eats up a large part of OWCP's administrative budget. So as a word of warning from my twenty years in private service, in public service, replacing accountable federal employees with private vendors does not reduce costs. It reduces accountability. And my experience tells me that contractors are not rewarded for improving programmatic outcomes.
They're rewarded for reducing costs on one side of the grand bargain. And, obviously, the easiest way to reduce expenditures is to delay, deny, or complicate care. But proposals framed as cost savings often don't eliminate costs at all. They shift them. When workers cannot access care, those costs are just shifted to private health insurance, to Medicare, Medicaid, or other private or public programs such as the VA.
That's not savings. It's shifting costs, and it's real. During my tenure at OWCP, I established a working group to improve physician participation and access to care, but its effectiveness was limited by the necessary reliance on an outside vendor that consumed significant resources, while contributing to the very barriers that were driving physicians out of the program. That situation should not be repeated by outsourcing even more of the federal work to for-profit vendors. There are other constructive changes that Congress should consider.
I've included those, list of those, within my written testimony, and I'm anxious to answer any questions you may have about those. I also want to note that if Congress wants to strengthen federal workers' compensation, I think the path is clear. Improve access to care for workers, reduce administrative barriers to allow physicians to practice with the federal programs, and ensure timely decisions, especially on wage-loss benefits. And finally, invest in the federal workforce that's responsible for administering claims of injured and ill federal workers. The grand bargain is endured because it reflects a very simple principle.
When workers are injured serving this country, the system should respond with prompt care, fair compensation, and dignity. Strengthening that system means honoring that promise, not outsourcing it to for-profit entities. Thank you, and I look forward to your questions.
Speaker 6
Thank you, Chair Mackenzie, Ranking Member Omar, and members of the subcommittee. I am Patrick Howe, executive vice president of Nuclear Care Partners. I started out as an army combat medic, but now my role is to support all of the nuclear care partners' patients through their continuum of care. Our company provides in-home health care across 28 states for former Department of Energy nuclear weapons workers. These patients suffered serious illnesses caused by their exposure to radiation and toxic substances.
Nuclear Care Partners strongly believes that these Cold War heroes deserve compassionate and exceptional care. In 2000, the Energy Employees Occupational Illness Compensation Act became law. It allows former energy workers with illnesses related to their workplace exposure to receive compensation and medical benefits. This health care program is run by the Department of Labor's Office of Workers' Compensation. This program is in urgent need of modernization.
Congress should pass the Healthcare for Energy Workers Act sponsored by representatives Alan and McBath. This, by parts and legislation, will modernize the 25 year old statute to improve health care for these heroes. The current statute only allows physicians to order care for these patients. This new bill would update the statute to allow care to be ordered by nurse practitioners and physician assistants in accordance with state practice laws. The current outdated policy has had devastating effects.
Patients are not receiving timely health care. Many of our patients, especially in the rural areas, face long delays in securing physician appointments. Many patients are forced to travel long distances to see a physician. For example, one of our New Mexico patients had to make a four-hour trip to see his kidney doctor. This was very taxing for the patient.
There were nurse practitioners who could have seen him closer to home, but the current policy does not allow it. In addition, the care authorization process and paperwork are challenging for physicians. Sometimes it makes it difficult to find a physician who is even willing to work with patients in the DOL health care program. HR 41 22 would improve the health care and quality of life for these patients. It would also align the DOL energy workers' program with the VA and CMS systems.
These systems utilize nurse practitioners and physician assistants as key participants to deliver health care to patients. In conclusion, we must update the energy workers program to reflect care models in the year 2026, not 2020. We urge the house to pass this much-needed legislation to improve health care for these atomic heroes. Thank you for the opportunity to testify, and I look forward to your questions.
Speaker 1
Thank you. Appreciate the opening testimony from each of you. And now we'll move to member questioning of the witnesses under committee rule nine. We'll ask questions of each of you under the five-minute rule, and I'll recognize myself for a couple of questions. First of all, I'll go to Mr. Hal.
Thank you for your service. We appreciate that. And you are talking about Yokba or the energy compensation program that the department administers, and it was enacted more than a quarter century ago. There are likely to be eligible workers, though, who aren't even aware of the program or they aren't aware of the extent of the benefits and the medical care that could be offered to them. In your experience, to what extent are eligible workers aware of this program, and what strategies could be used to improve outreach and enrollment?
Speaker 6
Yes. Thank you for the question. We still find workers who are not aware of the program and their right to enroll in the program. A lot of the outreach is currently performed by companies like Nuclear Care Partners. We host community events, educational seminars.
We do mailers. About 40% plus of our referrals come from current patients, so it's a lot of word-of-mouth. So going into the community and finding these individuals is one step, and then educating them on their potential benefits is another. One way that we can improve awareness is to work with the DOL and their resource centers to help identify a list of former employees, former workers, and then have regular communications from the DOL with updated educational packets, information, updates to the programs on an annual basis. This would help to drive awareness and education.
Speaker 1
Next, I'm gonna go to Miss McLeod. Your written testimony described the use of artificial intelligence to optimize claim processing, improve risk assessment, and drive operational efficiencies. What are some of the examples of how you're using this technology?
Speaker 4
Auto adjudication is one of the first ways that we've been using AI. This allows certain allowed conditions, minor scrapes, cuts, bruises, to process much faster than with human hands touching them. So within days of receiving the claim information, we're able to approve claims and notices to injured workers and employers, all with little or no staff intervention. Employers, of course, and injured workers, if need be, always have the option to file an appeal on any claim, including those auto-adjudicated. But this allows our staff to spend more time on complicated, high severity claims.
We're also working on auto-indexing. We get about four to 5,000,000 documents a year, and through auto indexing, we're able. Our initial estimate is that we can be able to get those scanned in and auto indexed at about 25 to 30% of those documents, with our ultimate long term goal being 80 to 90% of those. We have what we call a ChatBWC policy bot. This is an internal, it's all of our policies, all of our statutes, all of our rules that allow staff to find answers quicker, more efficiently, more thoroughly. They're all sourced.
Everything in our AI world, when we're summarizing, when we're getting those kind of answers, everything is sourced for them so they can go to the source document. This is, if we can scale this enterprise-wide, we expect to save about 20,000 hours annually. We have something called data chat, which allows our staff to ask natural language questions, but it puts them into structured query language. It improves access to insights and saving about 500 hours a year is our estimation. We, of course, the basic use of AI document creation, generating summaries for legal fraud, claims processes.
This saves, of course, thousands of hours. And then we're exploring using Microsoft Copilot. That's an AI assistant, boosts productivity in Word, Excel, PowerPoint, Outlook, Teams. It helps users generate content, summarize, automate tasks, and collaborate more efficiently by using AI in their workflow.
Speaker 1
That's great. It sounds like a very positive use of AI. We're glad to see the state government adopting that. And as a former state legislator myself and somebody who worked at our state department of labor and industry, one of the challenges we found in our structures were that statutes were sometimes so prescriptive in the workers' comp space that it didn't allow for innovation like that. So is it something that was in your state statute that was sufficiently broad that allowed you to do this, or did you have to seek some kind of change from the state legislature?
Speaker 4
To the chairman, thank you. The state legislature has allowed, and we have some restrictions on AI. We have statewide restrictions, not just my agency, but all agencies that put guardrails, especially on generative AI. But we have a statewide AI governance committee. Agencies must follow a formal process for identifying, documenting, reviewing, and approving all AI use cases.
AI solutions must align with the AI core principles for Ohio, which are fairness, accountability, security, transparency, and ethics.
Speaker 1
Great. Thank you. Appreciate that, insight into what's going on in Ohio. Next, I'll go to ranking member Omar for her questions.
Speaker 2
Since the nineties, more states have been enacting aggressive reforms to workers' compensation programs. Mister Godfrey, I want to discuss one of these common reforms in more detail. If the federal workers' comp programs adopt a managed care model, and force injured workers only to see physicians selected by OWCP or insurance contractors, how would this impact the doctor-patient relationship and the quality of care for injured workers?
Speaker 5
Thank you for the question. Generally, I think what we've seen with state workers' compensation systems, and I've seen it through my work with the IAI ABC, is that the best practices that we can have amongst agencies are really helpful to determine how to provide care. But I think the other thing that we've seen is through the data, some of it coming from the Workers' Compensation Research Institute, shows that when employer choice takes over in a system from employee choice, you actually see costs go up, which may be somewhat surprising. But I think the thing that we've seen from a policy perspective is that when injured workers are not allowed to select their own physician, there becomes a distrust within that system. Doctors may have treatment guidelines that preclude them from doing necessary testing for a certain period of time before they do things like physical therapy.
Certain medications may not be permitted under a statute. All of those things drive people from the workers' compensation system back to their private health care coverage, and that shifts the burden from a workplace injury onto the insurance, which is not meant for workplace injuries. So I think one of the things that we have to keep in our forefront, in our mind, is that when we look at who provides care, it has to be someone that provides prompt and adequate benefits, and it's someone that the worker will trust. That's the best outcome for a workers' compensation system.
Speaker 2
Yeah. And in your experience as director, and we talk a lot about those sources of waste, fraud, and abuse. But if we were to look at the workers' compensation program, is it the claimants or the providers that are the source of the waste, fraud, and abuse?
Speaker 5
I think what we've seen over time, especially as we look at the opioid crisis that we had in the United States, overprescribing of medications, compound medications, those are things that have really driven up costs in the federal workers' compensation programs, and that comes from providers. But I don't wanna say that providers overall because the vast majority of providers are, you know, the doctors and the physician assistants and nurse practitioners that we all use and rely upon. But we also heard, mister Johnson talk about waste, fraud, and abuse in workers' compensation and how SEDGWICK has systems in place. Well, the US Department of Labor also has the Office of Inspector General, and we work directly with the postal inspectors. So we have a very robust waste, fraud, and abuse system in place to drive out that type of fraud, to keep costs down.
And when we identify that, we work directly with the Department of Justice when I was at the Department of Labor.
Speaker 2
Thank you. Mister Johnson, your company Sedgwick has been repeatedly fined and settled claims with states. In California, you were subjected to over a million-dollar penalty for the death of an injured worker whose claim you all denied. In Tennessee, you were fined over utilization review that led to erroneous high treatment denials. In fact, the workers' compensation appeals board in California had this to say about your company.
I quote, we have rarely encountered a case in which a defendant has exhibited such disregard for its legal and ethical obligations to provide medical care to critically injured workers. I just have one question for you. Why is Sheridan Kwik so frequently cited for failing to provide adequate care for their workers?
Speaker 3
Thank you for the question, Ranking Member Omar. I don't know the specifics of those individual cases, but I would tell you just in my opening statement that that is not the way that we operate day in and day out. We operate from the sense of helping millions of workers that have been injured in their workplaces every year, get the best possible care, ultimately return to work. Those cases that may have had other extenuating circumstances, I can't comment on those. Certainly could follow up at some point in time.
But what I can tell you is that we have tens of thousands of colleagues of mine on the front lines across the country every day who are interacting with injured workers, who are learning about their personal lives, who are understanding what their injuries are, how they've taken place, what their goals are, and then ultimately are trying to use our systems, our data, our history ultimately to get them better, send them to the best possible treating providers, not the lowest cost providers in most cases. We're talking about those that produce the best outcomes, ultimately get well and return to work. That story repeats itself over and over again millions of times for us every year. So those individual cases can get some comments back to you on, but that's not the overall experience of our organization. And both of.
Speaker 2
I appreciate your answer. The record reflects otherwise. I have a unanimous consent request to enter into the record.
Speaker 2
Yes. I would like to read what I want to submit into the record. Okay. Okay. An exchange of three letters between ranking member Scott and myself and the Department of Labor about the department's oversight of self-injured coal operators, a letter from the workers injury law and advocacy group, a letter from the American Academy of Physicians Association, a letter from nine eleven Healthwatch to Citigroup's managed care advisers about poor service to survivors of the nine eleven World Trade Center disaster, an excerpt from a decision by the workers' compensation appeals board of the state of California referring to what the board calls it with disregard of the law, an excerpt from the Ohio inspector general report on questionable data submissions by care workers, CareWorks, a Sedgwick company, and an article from business insurance entitled, Sedgwick pays 1,500,000.0 to settle California comp violation.
Speaker 7
Thank you, Mr. Chairman. Thanks to the panel for being here. Let me follow up, mister Johnson. I believe a crucial sign of successful workers' compensation is a high rate of quickly returning workers to the workplace. That shows that they've received timely, effective care.
And these programs then, I believe, can focus on dollars needed for more patients who are in need. Let me ask you, what changes do you believe can be made to federal workers' compensation programs that could quickly translate to better return to work outcomes for injured workers?
Speaker 3
Thank you for the question, Chairman Wahlberg. The crux of returning to work is a coordination effort by multiple parties. Obviously, there has to be enough time and opportunity for the individual claims examiner to actively manage and proactively talk about the future with an injured worker and ultimately coordinate those activities with managed care providers and also the treating providers in the field. And once they have that, coordination and plan, and once they understand what their future medical maximum medical improvement is going to look like, then they can then go and coordinate with the employing agency or particularly other employing agencies ultimately to return that worker back to some production and productive action in society. We think that several things can happen.
Preferred providers are a big part of this. And, again, I'll talk about preferred providers from the sense of not those that are the least expensive, but those that produce the best outcomes, those that treat the most effectively, those that assign to physical rehabilitation in the most effective ways, and then, ultimately, those who coordinate return-to-work activities.
Speaker 3
Yes. So all of that has to be a big part of what goes on in the federal program going forward. We think that there are several things that can happen. One is improving the guidance and the training and the navigation with the injured worker themselves. This is all about helping the injured worker understand what their future looks like and how the system is ultimately gonna take care of them and make sure that they do get back into productivity in society.
That's another big part of it that I think can be improved in the federal environment at this time.
Speaker 7
Okay. Thank you. Mister Howe, in addition to your support for HR 4122, your written testimony also advocates for expansion of the telemedicine program and the options to energy workers. What would a more flexible telemedicine policy look like? And secondly, what are the limitations in telemedicine that we have to consider?
Thank you.
Speaker 6
For the question. Telemedicine would be an additional tool to connect patients with their clinicians. It was proven to be effective during the COVID era to have that communication and to provide care. For our patient population, several of our patients, all of our patients have to be renewed annually, and that is currently requiring a face to face visit. Like I said earlier, for some of these patients with the shortage of physicians, especially in rural areas, there's a lot of transportation or travel time to the physician.
And for some of our patients, they're very sick, and there some of them are even bedridden. So by offering telemedicine, it would be another venue for them to get the documentation and the meeting that they need to continue on the program. And, some of the limitations are telemedicine's not gonna work for every visit because if the patient's health condition is declining, there will always be a time when a clinician needs to have a face to face interview with the patient to make a good assessment. So telemedicine wouldn't replace face to face, but it would be a great tool to cut down on transportation time and provide convenience for these patients.
Speaker 7
A good option in the coordination of care. Correct. Thank you. Miss McLeod, how are managed care organizations maintaining the quality of participating care providers? Because we want the providers to be qualified.
Speaker 4
Thank you. Through the chair to chairman Wahlberg. Well, they must demonstrate a range so our experience, and, again, I can only speak to that, is that by bringing managed care organizations in, we've actually substantially expanded the number of providers in our system. In 1995, prior to managed care, we had about 273000 new claims each year. At that time, we had about 6,900 BWC-certified providers in the system.
Since managed care in this time, we now have about 67,000 new claims each year, but we have 91,869 providers in the system. Part of our requirement is that MCOs bring a robust panel to us, that they go out, that they get these providers BWC certified, that they agree to accept our fee schedules, our forms, our everything that it is to do, you know, the specific laws and requirements that BWC provides. We do have the option that every injured worker can choose their own provider, and we're actually putting together a little concierge service. If your provider is not in the BWC system, we will go out and help them get in the BWC system if they are willing.
Speaker 4
Exactly. That's exactly right. But you can if they are willing to be a BWC certified provider, you can go to any provider the injured worker wants to go to. Okay.
Speaker 9
Thank you, mister chairman, and thank you witnesses for being here today. The Federal Employees Compensation Act or FECA has not undergone a comprehensive modernization since 1974, even though state workers' compensation systems have evolved significantly over the last fifty years. Mister Johnson, as congress evaluates potential updates to FECA, what reforms would help improve coordination of care and recovery outcomes for injured federal workers?
Speaker 3
I think that the biggest thing that could be improved in the Fika environment is the provider arrangement. A network of providers that, again, are the most effective in treating workers' compensation injuries. Also, adjustments in the fees is a possibility, hopefully, that the networks are allowed to be paid along the way. We have a situation on many of our, we have over 900,000 active providers that provide the best treatment in workers' compensation. Our networks across the country produce those best outcomes that we talked about. We use historical data to judge those providers on their outcomes and, ultimately, the maximum medical improvement and return to work that they achieve for those injured workers.
We believe that in those cases, those similar aspects of the things that work so well in the private sector should be carried over and considered in the Fika environment also. We think that's the main driver that we would be a proponent for. There are other, obviously, changes to Fika that are on the table that, I'm not necessarily an expert in, but the one that drives the most, we believe, is on the provider side.
Speaker 9
Thank you. Miss McLeod, in your written testimony, you credit the adoption of managed care organizations as a fundamental element of the success of Ohio's workers' compensation program. Similarly, in my home state of Indiana, our workers' compensation system allows employers to coordinate care through designated providers to help get the injured worker timely treatment and return to work sooner. If we modernize FECA based on states like Indiana and Ohio, what would be the overall impact of using managed care networks with federal workers' compensation?
Speaker 4
Thank you. Through the chair, to vice chair, Mesmer. The impact for Ohio, again, what we've seen partnering with MCOs, help strengthen medical management of claims and improve outcomes for both injured workers and employers. And that's, of course, by improving the return-to-work outcome. Between 1998 and 2025, we've seen our file lag reduce from 30 days to 17 days, determination lag reduced by at least a day and a half, with our overall lag reducing about two weeks.
We've also, again, as I said, seen our number of providers grow substantially. It's gonna be important that the MCOs meet the geographical needs, including rural areas, but our MCOs in Ohio have made extra efforts to do that.
Speaker 9
K. Thank you. What potential consequences should Congress be aware of when considering whether federal workers' compensation programs should use a managed care model?
Speaker 4
Clinical guidelines that promote consistent evidence-based decisions reduce variability in case outcomes. A lot of communication, because MCOs can sometimes add complexity. There's sometimes a who's on first for the injured worker of who am I dealing with. Am I dealing with the managed care organization? Am I dealing with the federal employee?
Communication monitoring, we have a whole division dedicated, CPM, contract performance monitoring, that monitors our contract, our contract with our MCOs, with appendices probably about four to six inches on any given year. We're very proscriptive and prescriptive in what our MCOs can do. They work just for us. And then, of course, quality-focused incentives are gonna be necessary to manage the added burden.
Speaker 9
K. What metrics does the Ohio Bureau of Workers' Compensation use to measure performance of managed care organizations, and how can that model be used for federal legislation?
Speaker 4
The metrics that we use, there's some in the attachment to my testimony that I gave you that will show you what we do as a report card of every MCO. When we started, we had 57. We're down to seven MCOs because of, again, the stringency in the prescriptive and proscriptive. But, we measure through a combination of administrative metrics. We track baseline service expectations and outcome-based metrics to focus on safe and timely return to work.
MCOs that exceed these benchmarks can earn incentive payments, while insufficient performance can result in financial set-offs, and we have implemented those. We have also, this comes up in our, we certify all the MCOs about every two years. They have to go through a certification process to show that not only are they doing things as we go, but just to make sure that they're meeting those baseline standards. The report card helps, I think, a lot with the transparency for Ohio employers as they're selecting MCO businesses.
Speaker 1
Great. Thank you. Next, we'll go to the ranking member of the full committee, Mister Scott from Virginia.
Speaker 10
Thank you, miss, mister speaker, mister chairman. Mister Godfrey, if you're an employee, and get hurt on the job, you get lost wages, medical costs, and a disability if you're disabled. Which of those would you get if you're misclassified as an independent contractor?
Speaker 5
As an independent contractor, you would not qualify for workers' compensation unless you pay for insurance on your own.
Speaker 10
So you wouldn't get any of those as an independent contractor. You'd tell us the research, the relationship between private equity investment in health care and quality of care. Can you say something about that?
Speaker 5
Sure. Overall, private equity involvement in managed care and workers' compensation has been problematic for injured workers. It leads to cost shifting. One of the things that I have witnessed is that private equity can come into a workers' compensation system, basically be paid to take on high risk or high dollar cases. And then we know that because they receive that money, they are going to try to keep costs under the dollar value of what they basically were paid to take on the liability for that case.
And as you can imagine, that's going to lead to denials, delays, cuts in benefits to the worker, and, ultimately, that shifts to taxpayers.
Speaker 5
I think the investment, or the involvement of private equity, is somewhat new, so the data is not clear. But it is an area that we are looking at very carefully.
Speaker 5
Cost shifting means that when someone has liability for an injury or illness, if they can deny liability and force someone to go to a doctor with their private health insurance or if they're a veteran and they have qualifications at the VA, shifting their care to that facility so they can get more prompt and adequate coverage.
Speaker 10
Who sets the, who selects the doctors that are able to handle workers' comp cases on the federal level?
Speaker 5
On the federal level for the FECA program, 5 USC 8103a says that the injured worker gets to choose their own physician.
Speaker 5
The fee schedule is set annually by the United States Department of Labor. It is done in conjunction with other entities to make sure that it is a competitive fee schedule, which has cost savings, but also is competitive to keep doctors within the system.
Speaker 10
And are the fees set at a rate where doctors actually want to participate?
Speaker 10
Okay. You have mentioned the value of permitting schedule awards to be issued concurrently with wage compensation. What did you mean by that, and can it take place now?
Speaker 5
I have concerns with the current administration of schedule awards. A schedule award is compensation that's paid to a worker in an accepted claim because of the loss or loss of use of a scheduled member, for instance, an arm. If you have your arm amputated because of a workplace injury, you should be compensated for that loss in addition to the wage loss compensation that you're receiving, because you cannot go back to the same job you were at before. It is pretty well settled in workers' compensation that those are two separate elements of damages. Under the current administration of the FECA program, they are not paid.
They're only paid consecutively. So if you want to receive a schedule award, you have to stop receipt of wage replacement benefits. I think that is an improper administration of the law, and I would urge Congress to take a look at that.
Speaker 10
Well, so do you think it's a violation of the law, or they just sort of change the practice?
Speaker 5
I think that the regulations and procedures of the office workers' compensation should be reviewed by Congress to make sure that people are paid schedule awards that they're entitled to under the law.
Speaker 1
Thank you. Next, we're gonna go to Mr. Grossman from Wisconsin. Oh, cow. You can have a moment to get settled.
Speaker 11
We'll start with mister Howe here. As we evaluate the effectiveness of the energy workers' program, I want to make sure I'm getting the full picture. What metrics should be used to assess the energy workers' program?
Speaker 6
Thank you for the question. Critical metrics that we should use is the time we identify a potential patient to the time they receive care and go through the approval process. This is a metric that we want to make sure is as fast as possible. The bill that we are discussing today would be a critical, positive opportunity to shorten that time. Access to nurse practitioners and access to physician assistants will increase or shorten the time to get that initial visit, and that'll shorten the time to get the documentation to the DOL for them to make their determination.
So I feel a priority metric is the timing from identification to delivery of care.
Speaker 11
Thanks. What enhancements could we make to the claims process to better support the claimants and improve their experience?
Speaker 6
Yeah. Anything we can do to support and facilitate the process of getting approved. The important component of this program is you have to identify your work history, you have to identify your exposure, and then that has to coincide with the disease or the illness that you're suffering. So there's a lot of paperwork and a lot of assessment that's done at that time. The critical piece of that is getting with the clinician to make that assessment, and determine if these are all linked together.
So speeding up the process is key to that, and I firmly believe that this bill will help to do that.
Speaker 11
Okay. We'll switch to Mr. Johnson here. Your written testimony highlights several applications of artificial intelligence in workers' comp. However, you also recognize the need for proper control and safeguards. How can we make sure the balance, how can we balance an effective use of AI while also making sure these programs safeguard patient privacy?
Speaker 3
Thank you for the question, representative. In our view, the use of AI has been very powerful in the claims management arena, mainly in assisting the claims examiner to properly identify trends, upcoming milestones, help the injured worker in a better possible way from historical learnings, and then ultimately supplement the way that they're able to effectively do their job. What we believe in the use of artificial intelligence is that there should always be a human on both ends of the transaction. There should be a human that evaluates the ultimate case that is before them and then ultimately manages that case throughout its continuum using the AI tools to supplement their abilities as a person and one person managing numbers of cases. And then ultimately, a human that reviews the outcome and decides whether or not that AI recommendation was the best, was the best care, was the best procedure, and the best ultimate outcome for that injured worker.
We think that oversight and that constant monitoring of the AI that's involved in claims management is the utmost importance. We also think the data should remain internal. The data needs to remain within federally compliant systems. We believe that only certain tools should be used in the AI world, and that needs to be closely governed. So all those controls that are in place in the AI environment, we believe, are of the utmost importance to be able to make sure that claims are managed effectively, and ultimately, the injured worker gets the best possible outcome.
Speaker 11
Can you give us any specific examples of success stories of patient privacy safeguards being implemented as part of AI usage?
Speaker 3
I think keeping those within the federal environment that are already of the utmost cybersecurity requirements is key in any one of these discussions and any one of these rollouts. The fact that we've got, you know, we do constant reviews of these programs, making sure that all of the cybersecurity efforts that are in place for any federal program and sharing of information back and forth are ultimately present in any AI that becomes involved with a particular claim. So none of that ceases it actually, increases in scope, if you will, given the fact that we're bringing in now an additional party in, in weighing in on the ultimate management of a claim.
Speaker 11
Miss McLeod, I'm gonna ask you kind of a broad question. If I go back home and ask people what they think about the workers' compensation program, they always have anecdotal evidence of the program being abused. Could you comment on that on a scale of zero to 10? Where do you think we are as far as putting together a good workers' comp program without the people? It seems that people who are genuinely injured don't get the workers' comp, and the people who aren't injured are the ones who end up getting it.
So can you comment on where you think we are right now as far as putting together a successful program?
Speaker 4
Thank you, through the chair, representative. I can speak to Ohio, and Ohio's experience is not that. We have a robust fraud program, of course, both that investigates employers as well as injured workers. But, we do not see, we've identified a lot of savings, but we do not see the level of fraud either in injured workers or in employer efforts. Certainly, we've seen in the past just by getting injured workers back to work quicker has helped quite a bit, as well as our work with the managed care organizations.
Speaker 13
Thank you. Thank you, Mr. Chairman. Look. I think this is an important issue because we have two competing things that we need to balance. One is we should be making sure workers who get injured, particularly federal workers, are taken care of.
I don't think anyone disputes that. But as we've seen in virtually every program in this country where the government takes money and gives it to someone, there is massive, endemic, and crippling fraud, which will lead ultimately to the collapse of our country if we don't get these things under control. And one of the things that amazes me in this situation is that you're getting workers' compensation. Right? So you're compensated for not being able to work.
But then when you wouldn't be able to work anyway, you're still compensated for not being able to work. The idea that people that are retired or continuing to get workers' comp is simply offensive, I think, to the American people. So, a few questions. Mister Johnson, as you state in your written testimony, government-funded programs should have integrity and prevent fraud. How does the use of predictive analytics, which frankly I was working on 20 years ago, enhance fraud prevention and overall program quality?
Speaker 3
Thank you for the question, representative. Well, first of all, we leverage predictive analytics to identify risk, not to presume wrongdoing in any way. So we're trying to understand the patterns that are involved in any particular workers' compensation case and patterns that may be anomalies when compared to larger sources of data. That's one of the benefits of organizations that manage multimillions of workers' compensation claims, is the fact that the data elements behind the scenes are so robust that we have the ability to mine those on a constant basis and take a look for those anomalies, not just on potentially the claimant side, but also on the provider side. So we look for anomalies in the treatment patterns, the prescribing of medications, the utilization of rehabilitation efforts, all of those things that come out of our system, and look at those patterns in the data from the past cause us to then say that a human needs to take a look at this a little bit further.
It's not the system ultimately making that decision, but the use of all that data, artificial intelligence, and those predictive analytics allow the humans to focus in, and then dig into that case and get an understanding as to whether or not something needs to be pursued there because of some potential wrongdoing.
Speaker 13
Okay. So what barriers follow-up for you. What barriers have states in your own organization encountered when trying to implement this technology?
Speaker 3
Most of the time, states are concerned about overdoing it, overreporting. And so you don't wanna get a situation where, you know, they wanna see legitimate cases. They have a certain amount of resources and power to be able to review cases themselves when we're turning in packages for them to examine. And so they get most of the time they're concerned about the fact that there's a certain standard that needs to be met before those packages turn in. But most of the time, people can understand that we're legitimately looking for these patterns and having a notion about whether or not there's something untoward that's going on there.
Speaker 13
K. Shifting focus, I've got two minutes left, Miss McLeod. A question for you. Your written testimony notes the significant reduction in the average time for injured workers to file a claim since your agency made significant changes to its operations 30 years ago. What improvements is the Ohio Bureau of Workers' Compensation continuing to make to improve its efficiency in serving injured workers?
Speaker 4
Thank you for the question, through the chair. To the representative, we do a triage-based claims management system that creates experts in each phase of the claim that can help the injured worker with a higher level of expertise. We have a specialized team for our occurrence needs. We've spent a lot of time when the pandemic hit, we put together a COVID-19 claim group to make sure that they got the special attention that they need. We do the same for claims that involve more than 3 injuries, catastrophic claims, and any complex claims.
They have individual staffing groups that they meet regularly, working with the MCOs and the employers to try to help those injured workers. We've increased communications, text messaging, email notifications, etc. I've talked a little bit about automatic claims processing and, working a lot in the vocational rehab with what we call a program called Ohio Means Jobs, and it's to help those injured workers find work even if it's not in the job, if they're unable to return to their previous employment. How do we get them back to work? Because what we know in workers' comp is the longer you're off work.
So getting people into a job where they can be successful. And as Governor DeWine would say, live up to their God-given potential and be able to reenter the workforce. We work hard on that with our MCOs.
Speaker 13
Well, thank you. Thanks for working on this. It's an important issue, and thanks for being here today. Mister chairman, I yield back.
Speaker 8
Thank you, Mr. Chair. Thank you very much. Thank you, chairman McKenzie, but also thank you to all the ranking members of the entire committee, chairman Scott and ranking member Omar, for allowing me to sit in today. Thank you so much for letting me wave. And thank you to our witnesses today for convening this important discussion on how we can better support our public servants who have given years of their lives to service.
For our federal workers who have worked at our nuclear sites, the energy employees occupational illness program is a lifeline. Providing compensation and medical benefits for current and former workers who have gotten ill on the job. However, our energy workers who qualify and are living in our rural areas often face very long wait times and unnecessary delays for just routine, and lifesaving care. It is why I am proud to partner with my colleague across the aisle, my Georgia delegation member, congressman Rick Allen. We have both partnered on this legislation that would cut the red tape and improve access for our public servants.
The Healthcare for Energy Workers Act would modernize an outdated provision that unnecessarily restricts access to care for those who live in health care deserts, ensuring that our public servants have access to the care that they need, what they need, when they truly need it. Georgia is home to over 7,000 energy workers, many of whom are current or former workers who benefit or qualify under this program. But we are facing a critical shortage of medical providers in our home state. Those problems compound as you get further out of the Atlanta metropolitan area. There are 42 counties in Georgia that do not have an internal medicine doctor, 10 counties that have no physicians at all.
And for the people living in Webster, Montgomery, or Chattahoochee County, the provider shortage forces six patients to travel long distances to receive care that could otherwise be offered by providers closer to home. This is an issue that deeply impacts our neighbors in Georgia. This is an issue specific not just to Georgia, though. As our country as a whole struggles with a nationwide provider shortage, so many Americans, especially in our rural communities, are being left behind. But the area you live in should not dictate how long you must wait for life-saving care.
Right now, our rural neighbors are feeling and bearing all the brunt of the pain, running up the tally on hours spent on the road so they can get the lifesaving care and routine treatments that they need. Like our neighbor down in Coweta County, where after years working as a pipe fitter at a nuclear site, he settled down in Sharpsburg, Georgia as he battles cancer and pneumo... Pneumoconiosis, a severe and irreversible lung condition caused by inhaling toxic dust. The current law forces him to regularly drive over six hours round-trip in order to verify his health benefits. Our federal workers definitely deserve better than this.
Mine and congressman Allen's legislation will modernize the program to reflect the shortages that patients are facing on the ground. This bill gives patients the ability to work with providers that they already have built a relationship with, and who are already in their communities. Gives back patients their time. Time not spent driving for hours in a car, not worrying about when they'll be able to find an appointment for their next physician's visit. More time to heal in the comfort of their own home, and more time with their families and their communities.
Mister Howe, can you share a little more about the specific health issues that our energy workers face and why timely access to their care is essential for these patients?
Speaker 6
Yes. Thank you for this very important question. You mentioned pneumoconiosis. We do see a lot of respiratory illness, specifically silicosis and asbestosis, two forms of pneumoconiosis. We are also seeing a significant increase in chronic kidney disease related to heavy metal exposure like cadmium, lead, mercury, and this is something we're proud of.
Nuclear Care Partners created the first of its kind in-home dialysis care for these patients. We're very proud of that. We also have specialized care for respiratory illnesses. There are also neurological defects, but the one that you mentioned was also cancer. There are 22 forms of cancer associated with exposures to these toxic materials and radiation.
And patients who are in the end stages of cancer, earlier stages of cancer, delaying care for them even by a week, a month, or two months to get a physician's appointment would delay the entire process of getting approved. Some of these people don't have the gift of time. And at Nuclear Care Partners, we are fighting to get into that home, and I want to sit in the chair of a patient and their family for just one second. We're fighting to get into that home to give them care and comfort as they transition. And if we're delaying things because of access to physician care or getting the proper documentation, we're delaying that care that we can get in.
We fight to get in even for one day to provide care and comfort for that support. You also mentioned transportation, a pneumoconiosis patient that has to drive 6 hours. It's very likely that if they're not already on, they will be on permanent oxygen for their disease. Think about the transportation and driving with an oxygen tank for six hours and being fearful that tank could run out. Time to get an appointment, time to get care is critical.
This bill will help several people. It will help them. It will provide better quality of care. And this is, at Nuclear Care Partners, our passion. And we thank you so much for bringing this bill to life.
Speaker 8
Well, thank you so much. I'm out of time, but thank you for caring for our energy patients. Thank you. I yield.
Speaker 12
Well, not to repeat this subject, but I wanna thank you, Chair McKenzie, for allowing me to weigh in to this hearing. And I thank the witnesses here for testifying. And I wanna thank Nuclear Care Partners for its support of HR 4122, the Health Care for Energy Workers Act, which I introduced alongside Representative Georgia. This legislation is important in updating energy employees' occupational illness compensation program act, which is the EEOICPA, to allow nurse practitioners and physicians assistants to order care for current and former Department of Energy workers who receive health care under this Department of Labor program. Georgia's 12th District is home to thousands of energy workers employed at Plant Vogtle and Savannah River site, many of whom qualify for the EEOICPA for their health care needs.
However, those who live in rural areas, as representative Macbath mentioned, are often hours from the nearest physician, allowing for the need for greater flexibility to ensure these beneficiaries receive the care that they deserve. This legislation addresses an unfortunate reality, that there is a critical shortage of eligible care providers in many parts of this country. And by cutting unnecessary red tape and improving access to care for energy workers in Georgia and nationwide. In addition to allowing, Miss Howe, in addition to allowing patients to seek more local care options, how else can HR 4122 reduce administrative delays, increase program efficiency, and reduce overall cost by allowing, you know, these providers to actually help folks in these rural areas?
Speaker 6
Yes. Thank you for the question. It will reduce delays by improving speed of access to the care providers. Like you said, getting care by a nurse practitioner or a family physician assistant in your local community will much, will be faster. It's going to reduce redundancies because certain situations now where a patient has seen a nurse practitioner or physician assistant, they would also have to go see a medical physician to get the proper documentation.
So it's a duplication of services. So that's not efficient. Most importantly, is the savings of cost. Mhmm. Our health care system is burdened.
Our hospitals are full. And we know through our nursing programs, and a big goal at Nuclear Care Partners is to get nurses into the home where we can assess patients, we can reduce complications, and subsequent hospital visits. We can reduce costs by preventing patients from having to go to the hospital. The faster we get in the home, the better we can keep these patients healthier, keep them out of the hospital, and reduce costs to the system.
Speaker 12
Well, you know, the other thing we did, through the Work and Families Tax Act, is provided additional resources for our rural hospitals. And, what I've experienced with our rural hospitals, you know, the telemedicine program has been around. Actually, it started there in my district at Augusta University, and it's been around since 1960. It evolved in COVID, obviously, heavily. And, in fact, now you can walk in at a hospital, and you can get within sixty seconds a physician from Augusta to look at the issue and provide the care.
And so I think that is a big plus, that we need to, which would be included in HR 4122 to allow these nurse practitioners and others to get immediate care for our patients. In your retina testimony, calls for passage which would allow nurse practitioners and physician assistants, which we talked about, to order care for patients in the energy workers program. Are there other federal health care programs already allowing nurse practitioners and physician assistants to order care?
Speaker 6
Yes. Currently, both the VA and the CMA CMS systems allow nurse practitioners and physician assistants to provide care and write for care.
Speaker 6
I can't speak for why the program hasn't adopted the practice. I can speak to conversations I've had with people who have spoken to members of the DOL that they do not have the process or the law in place to make these changes. Right. So that's why I'm making this bill. This bill is so important.
Speaker 6
We need the legislation to make the change, to get us equal to both the VA and CMS systems.
Speaker 12
Okay. Great. Thank you. I'm your back. I'm out of time.
Thank you, miss chairman McKenzie, for allowing me to weigh in, and thank you to the witnesses.
Speaker 1
Thank you. That concludes member questioning. I appreciate all of the testifiers for their responses. We will head to closing remarks, and I'll recognize the ranking member for her closing statement.
Speaker 2
Thank you, mister chairman, and thank you again to our witnesses for sharing their testimony with us. Today's discussion reminds us that the federal workers' compensation programs are not just a line item in a federal budget. They are a promise. A promise that when federal employees are injured while serving the public, they will not be abandoned. Whether it is a postal worker delivering mail or a firefighter battling wildfires on public land, these workers perform essential duties every single day in demanding conditions and deserve our support when things go wrong.
When an injury happens, the impact extends beyond the workplace. Families might face lost income, medical bills, and uncertainty about the future. Programs like FECA provide stability in those moments, making sure that injured workers can access medical care, receive wage replacements, and, when possible, return to work once they are recovered. At the same time, these laws are quite old. FICA is mark is more than a century old, and the energy workers' program recently marked its 25th anniversary.
So it is appropriate for Congress to review how the programs are functioning and whether improvements can be made. Those discussions should start with one guiding principle, strengthening the system so it works better for the workers it was created to serve. Reforms that improve efficiency and support recovery are important, but they should never come at the expense of fairness or sacrifice every protection that injured workers rely on. If we keep workers and their families' experiences at the center of this conversation, we can ensure the workers' compensation continues to uphold the promise it was created to fulfill. Thank you, Mr. Chairman.
Nail Beck.
Speaker 1
Thank you. Well, I'd like to thank everybody again for joining us today and discussing ways we can improve federal workers' compensation programs, care for injured workers, and return-to-work outcomes. By cutting through red tape, simplifying paperwork, and embracing digital solutions, we can reduce administrative burdens and ensure injured workers receive the compensation they deserve without unnecessary delays. As today's witnesses have highlighted, there is also a clear need to increase access to care for program claimants. Fortunately, there are bipartisan solutions that address these problems, some of which were discussed today.
We must advance policies that reduce and prevent abuse of the system as well and provide greater access to care for critical needs that our workers face. With that, again, I'd like to thank everybody for being here, especially our testifiers. We appreciate your testimony and for traveling to join us today. And without objection, there's no further business before the committee, and the subcommittee stands adjourned.
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