1. 1 Division of Workers’ Compensation Workers’ Compensation Information System

2. 2 Goals for WCIS Help DWC Manage WC system Facilitate Evaluation of Benefits Delivery Assist in Measuring Benefit Adequacy Provide Statistical Data for Research

3. 3 Components of WCIS First Reports—FROI Subsequent Reports—SROI Medical/Bill Payment Reports

4. 4 Status Report: 2005 & Beyond Data Collection & Uses to Date System Reconfiguration Plans for WCIS Unresolved Issues

5. 5 Data Collection – First Report of Injury 2/20042/2005 Trading Partners –Relationships Initiated 256271 –Submitting Data205216 Claims3.0 m3.9 m

6. 6 Data Collection – Subsequent Reports 2/20042/2005 TPs Submitting Data 6980 Claims403 k520 k

7. 7 Data Uses to Date DWC DOSH DLSR CHSWC DHS LAW ENFORCE EDD WCIRB LEGISLATURE RESEARCHERS

8. 8 Current Programmed Reports Injuries by Part of Body, Nature, Cause Workers’ Demographic and Work Characteristics Claims by Industry and Region; Benefit Category; Insurer Type Timeliness of Benefits Delivery Cost of Injuries

9. 9

10. 10 Tables/Reports on WCIS Webpage Tables: Nature of Injury Part of Body Cause of Injury Injuries by Age and by Gender Claims by Type of Insurer Report: Age & Gender by Insurer Type, 2000-04

11. 11 Database to Date: Tip of Iceberg Medical Data Collection Beginning Soon Benefit Data with Two Years’ Maturity Commenced only in July 2002 Robust Indemnity Data Requires: -Established Baselines for Comparison -Developed Claim Maturity

12. 12 WCIS Redesign & Enhancement CA ~ 1/8 of USA 2002-04 System Redesign Medical Data Collection

13. 13 2001-2 Claims to WCIS vs. ARI WCIS Approximately 80% of ARI Large Commercial Insurers Comply Small TPs and Public Jurisdictions Lag SROI Reporting Lags

14. 14 Current Compliance Issues Alternatives to Update SROI Information –As per Implementation Guide –Submit UR and IP Compliance Activities: 2003-05 –Set Deadline for Compliance –Require TP Data Submission Plan –Establishing Penalties (FROI/SROI/AN/FN)

15. 15 Other Potential Innovations Add SIC/NAICS Industry Codes Report AN on Claim Anniversary Accept Future MTC and Benefit Start Dates Permissible Uses of UR Other Suggestions? (Adv Cmte Mtg--May)

16. 16 IAIABC Med Implementation Guide (7/02) CA Medical IG (2/05) Timeline for Beta Testing & Regulations IAIABC Medical Data Collection

17. 17 Medical Data Reporting Trading Partners Beta Testing Electronic Billing Standards OAL Regulatory Process

18. 18 Rulemaking Changes Standard Billing Forms Overhaul of CA FROI/SROI IG Med Data IG Compliance/Penalties

19. 19 Other Topics WCIS Reports, etc. on Website TP Suggestions Welcome

20. 20 Integration and Future Design EDD Linkage WCAB, VR and DEU Database Links EDI Release 3

21. 21 Med Issues & Legislation Repeal of Treating Physician Presumption Medical Treatment & Quality in WC Study Fee Schedules Access Study Etc.

22. 22 Conclusions Re: WCIS Significant Advances Continuing Challenges

23. 23 Wrap–Up and Next Steps Address Questions and comments to: Bill Kahley 415.703.4678 bkahley@dir.ca.gov