▶ 0:07:15This subcommittee on workforce protections will come to order. I note that a quorum is present. Without objections, the chair is authorized to call a recess at any time. Today's hearing will examine programs in the Department of Labor's Office of Workers Compensation Programs, also known as OWCP. Since its establishment in 1916, OWCP has supported workers who experience an injury on the job or develop an occupational disability or disease.
▶ 0:07:45Through these programs, workers and their families may receive wage replacement benefits, medical treatment, vocational rehabilitation, and other assistance. As part of its duties, OWCP administers the Federal Employees Compensation Act, also known as FECA, and the Energy Employees Occupational Illness Compensation Program Act, long much longer acronym.
▶ 0:08:10Uh and these programs provide billions of dollars in benefits each year to the hundreds of thousands of workers who depend on them. These programs play a critical role in supporting injured workers, which we heard about during our hearing on this subject just last year. Following that hearing, we received valuable input, observations, and perspectives from stakeholders.
▶ 0:08:32Today's hearing gives us an opportunity to build on what we've learned and seek out common sense improvements to these programs that help injured work workers access high-quality care and return to their careers. HR 4122, the Healthcare for Energy Workers Act, introduced by committee members Allen and McBath, is one example.
▶ 0:08:55This bipartisan bill would expand access to qualified providers and reduce delays in care by providing or by allowing nurse practitioners and physician assistants to order care in this program. Last year, the committee unanimously approved a similar bill introduced by Chairman Walberg and Representative Courtney, the Improving Access to Workers Compensation for Injured Federal Workers Act, which amends FECA.
▶ 0:09:23Together, these bills cut unnecessary red tape and help to reduce the hurdles that injured workers are forced to jump through in order to receive the care that they need. By embracing solutions like this, we can deliver the savings and efficiency that taxpayers deserve, while also streamlining the care that injured workers count on. In addition to these reforms, we should consider ways to help OWCP run their programs more efficiently.
▶ 0:09:49Many state workers compensation programs have adapted to the evolving technology and healthcare landscapes, identifying best practices for these programs or from those programs could help our federal programs improve in terms of efficiency and connecting workers with quality care.
▶ 0:10:06From adopting artificial intelligence for assistance in claims processing to strengthening predictive modeling, these practices could help reduce administrative burdens, streamline care, and save money for the American I look forward to hearing from today's witnesses about their perspectives and their recommendations on how these programs can better be better serve injured workers while ensuring that they run efficiently and operate responsibly.
▶ 0:10:33With that, I'd like to yield for our ranking member for her opening Thank you, Mr. Chairman, and thank you to our witnesses for being here. At its core, workers' compensation represents a uh promise we made to the people who keep this country running. To the federal employees who deliver our mail, inspect our food supply, and care for our veterans.
▶ 0:10:58To the miners and energy workers who power our economy, and to the longshore and harbor workers who keep trade flowing and maintain our mastery of the seas. When those workers are injured on the job, federal workers' compensation programs ensures that they are not left to face the consequences alone. When a worker is hurt on the job, it often disturbs their lives and their families' lives.
▶ 0:11:23And a serious injury can mean months without a paycheck, mounting medical debt, and uncertainty about whether a worker will ever return to their job. Workers' compensation provides stability in those moments through wage replacement, medical coverage, and rehabilitation support. Across the country, however, many worker compensation systems are slowly being eroded.
▶ 0:11:47Over the past several decades, states have reduced benefits, narrowed eligibility, and added administrative Many injured workers receive less support precisely when they need it What is complete That is completely unacceptable. The federal workers' compensation programs should not repeat those same mistakes.
▶ 0:12:09The workers covered by these programs, from federal employees to coal miners, perform work that the public relies on and often is demanding and dangerous The system that protects them after an injury should reflect that reality. Unfortunately, in recent years, worker protections have not been prioritized.
▶ 0:12:29President Trump's deregulatory agenda rolls back safeguards across many areas of workplace safety policy and enacted in Trump's big ugly bill have contributed to an environment where protecting the health of workers is more difficult. That makes it even more important that programs like FECA remain strong, [snorts] accessible, and centered on workers' needs.
▶ 0:12:54We should be careful not to weaken one of these key systems that employees rely on when they are injured on the line of We must always ensure that cost of workplace injury and illness are not borne by workers and their families, but instead paid by the employees who create unsafe workplaces.
▶ 0:13:13And on that note, I hope we can spend some time in this hearing exploring the Labor Department's apparent decision to abandon the 2024 final rule on the amount of collateral that needs to be reserved by self-injured coal mine We have seen hundreds of millions of dollars in black lung liability shifted onto the taxpayers after self-injured operators who had posted too little collateral went bankrupt.
▶ 0:13:41Ranking Member Scott and I have asked to come clean with the public about what they are doing to protect taxpayers and hold corporations accountable. But the department has so far failed to give us any straight answers. However, I am encouraged that our workers' compensation programs have long been an area of bipartisan cooperation. Members on both sides of the aisle have recognized that supporting injured federal workers is not partisan.
▶ 0:14:08It 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 workers? Any discussion about changing workers' compensation must start by centering the rights and livelihoods of American workers.
▶ 0:14:36Since the cost of workers' compensation is often a direct result of 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 FECA was created to uphold.
▶ 0:15:00Most importantly, the voices of workers and their families must remain part of this 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.
▶ 0:15:24I look forward to hearing from our witnesses about FECA is working in practice and how Congress center it to continue to serve the federal worker workforce effectively. Thank you, and I yield back. Thank you. Pursuant to committee rule 8C, 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 5:00 p.m. 14 days after this hearing.
▶ 0:15:52And 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 going to 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 Ms.
▶ 0:16:21Stephanie McCloud, administrator and CEO at the Ohio Bureau of Workers' Compensation Programs in Columbus, Ohio. Our third witness is Mr. Christopher Godfrey, the director of research at the Workers' Injury Law and Advocacy Group in Washington, D.C. And our final witness is Mr.
▶ 0:16:39Patrick Cow, an executive vice president at Nuclear Care Partners in Grand Junction, Uh we're going to uh 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 3-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.
▶ 0:17:07Pur- Pursuant to committee rule 8D 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. Thank you, Chairman McKenzie. Thank you, Chairman Walberg. Ranking Member Omar, Ranking Member Scott.
▶ 0:17:35Uh members of the subcommittee, I'm very pleased to be here today and appreciate the opportunity to to meet with you. Or- 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 that are in a time of need. Uh they are they've been injured at work.
▶ 0:18:04They are worried about what's going to go on. They are confused by a system with lots of rules. They have uh 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 uh day in and day out. Our motto is caring counts, actually. That's the way we go about our business, and they depend on us.
▶ 0:18:29They depend on us to explain to them what's going to happen in 2 days, in 2 weeks, in 2 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 their injury. They want ultimately to for us to help them return to work.
▶ 0:18:51And they also want us to help them address on on often occasion uh mental anguish, because a lot of times the toll that a workplace injury takes affects a person's um uh mental uh faculties as well. So, that's always something that's in the back of our mind, and something that needs to to be addressed and and cared for. Uh 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.
▶ 0:19:18So, the things that we've been doing so successfully for over 5 decades, and particularly some of the new technological advances that have happened in the last several years, uh we're uh concerned that those don't have an opportunity to help federal workers in the same way as those workers that we um that we help and care for in the private sector and the public sector uh day in and day out. So, we want to talk about that and certainly answer any questions that we can.
▶ 0:19:42Uh the tech that we or talk about, we we believe is going to help in uh 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.
▶ 0:20:04If 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 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 Thank you for that. I'll yield back.
▶ 0:20:34Thank you. I'll now recognize Ms. McCloud for your testimony. Good morning, Chairman McKenzie, Vice Chair Mesmer, Ranking Member Omar, and members of the Workforce Protection Committee. My name is Stephanie McCloud. I'm the CEO and Administrator of the Bureau of Workers' Compensation in Ohio, the heart of it all. Uh we are responsible for the prevention and treatment of workplace injuries for six roughly 6 million Ohioans.
▶ 0:21:01We have about 250,000 employers in the state of Ohio that we work with. We have about 78,000 new claims each 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 service services to injured workers to managed care organizations or MCOs.
▶ 0:21:32These 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 to they are the providers. That is not the case in Ohio. Our managed care organizations uh 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
▶ 0:22:00and help get employees safely back to work after an injury. Prior to managed care dealing with Ohio's working workers' compensation uh program was very difficult and not very helpful. Uh at that time, it was then Governor Voinovich and then Lieutenant Governor DeWine. Some of you may recognize that name from former Representative DeWine, former Senator DeWine, former Senator uh Voinovich. Uh but we were referred to as the silent killer of jobs.
▶ 0:22:29The program did not run well, not for the employer, not for the injured worker, not for the state. Now we are considered an 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 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 cares, and statewide industry changes.
▶ 0:23:00Uh we've seen a lot of changes in our workers' compensation dealing since dealing with managed care. For instance, uh the average time for filing a workers' compensation claim before managed care was about 65 days, and determination within the first 2 weeks was about 1%.
▶ 0:23:17If you understand workers' comp, you understand this is not good 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 2 weeks. The result in the change of the managed care program, now named HPP, was initiated in March 1st, 1997.
▶ 0:23:40I've attached for you to my written testimony the agreement between all the parties that came to the table to 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 to this system, and to understand the system better.
▶ 0:24:07HPP applied two foundational principles to Ohio's 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 uh we we had some issues, if you think about um we reduction in workforce at that time.
▶ 0:24:35When we outsourced our managed care, we had a reduction in workforce. We were about 4,200 employees at the time, and as uh in the history of my long resume, which you have before you, I was actually at the Bureau as we I was actually [clears throat] at BWC as we were outsourcing. We worked with the employees to reassign them. We also engaged in a pardon [clears throat] me, in a buyout, a pension buyout, where we bought out many years of their pension so that they could retire early.
▶ 0:25:05That created a wave of hirings, actually. So, we didn't have people displaced for layoffs. We created a wave of hirings. 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 uh doing a lot of hiring, of course, and in the meantime trying to use AI to fill that gap.
▶ 0:25:33And I'm happy to answer more questions about that if you have those. Thank you. Thank you. Next, I'll recognize Mr. Godfrey for his testimony. Thank you. Good morning, uh Chairman McKenzie, Ranking Member Omar, members of the committee. Good morning, uh Chairman McKenzie, uh Ranking Member Omar, and members of the committee. Thank you for the opportunity to testify uh today regarding the federal workers' compensation programs administered by the Department of Labor's Office of Workers' Compensation Programs.
▶ 0:26:01I'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 uh at the state, local, uh and uh levels, including the Iowa Workers' Compensation Commission, uh chief judge of the Employees' Compensation Appeals Board, and the director at the Office of Workers' Compensation Programs at the Department of Labor.
▶ 0:26:27In 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 uh 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.
▶ 0:26:47Workers gave up their right to sue for civil damages in exchange for prompt and adequate uh compensation delivered through an administrative system, and the important words there are prompt and That balance has largely sustained the system for more than a century, and it should guide any changes that Congress uh considers. A particularly urgent uh matter right now in the federal system is access to medical care.
▶ 0:27:12The FECA program uh 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 uh to participate in the program. But the problem isn't the statute. It's the administrative burden surrounding medical authorization, billing, and reimbursement.
▶ 0:27:37And 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 uh budget. So, as a word of warning from my 20 years in private service and public service, replacing accountable federal employees with private vendors does not reduce costs. It reduces accountability.
▶ 0:28:01And my experience tells me that contractors are not rewarded for improving uh programmatic outcomes. They're rewarded for reducing costs for one side of the grand bargain. And obviously, the easiest way to reduce expenditures are to delay, deny, or complicate care. But proposals framed as cost savings often don't eliminate costs at all. They shift them.
▶ 0:28:25When workers cannot access care, those costs are just shifted to private health insurance, to Medicare, Medicaid, or other private programs like or public programs such as the VA. That's not savings. It's shifting costs, and it's 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
▶ 0:28:55barriers that were driving physicians out of the That situation should not be repeated by outsourcing even more of the federal work uh to for-profit vendors. There are other uh constructive changes that Congress should consider. I've included those a list of those uh within uh my written testimony, and I'm anxious to answer any questions you may have about I also want to note that if Congress wants to strengthen federal workers' compensation, I think the path is clear.
▶ 0:29:25Improve 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 federal workforce that's responsible for administering claims of injured and ill federal The The bargain's 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.
▶ 0:29:54Strengthening that system means honoring that promise, not outsourcing it to for-profit entities. Thank you, and I look forward to your questions. Thank you. Lastly, I'll recognize Mr. Hou for his testimony. Thank you, Chairman McKenzie, Ranking Member Omar, and members of the I am Patrick Hou, 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.
▶ 0:30:24Our 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 exposures 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.
▶ 0:30:51It 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 This program is in urgent need of Congress should pass the Health Care for Energy Workers Act sponsored by Representatives Allen and McBath.
▶ 0:31:16This bipartisan 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.
▶ 0:31:45Many of our patients, especially in the rural areas, face long delays in securing physician appointments. Many patients are forced to travel long distances to to see a physician. For example, one of our New Mexico patients had to make a 4-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.
▶ 0:32:13In addition, the care authorization process and paperwork is challenging for physicians. Sometimes it makes it difficult to find a physician who are even willing to work with patients in the DOL health care program. HR 4122 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.
▶ 0:32:38These 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 2000. 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 Thank you.
▶ 0:33:07I 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 5-minute rule, and I'll recognize myself for a couple of questions. First of all, I'll go to Mr. Hou. Thank you for your service. We appreciate that.
▶ 0:33:26And you are talking about EEOICPA, 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 could be offered to them.
▶ 0:33:50In your experience, to what extent are eligible workers aware of this program, and what strategies could be used to improve outreach and enrollment? 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 performed currently by companies like Nuclear Care Partners.
▶ 0:34:13We host community events, educational seminars, we do About 40-plus percent 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 is one step, and then educating them on their potential benefits is another.
▶ 0:34:32One way that we can improve awareness is to work with the DOL and their resource centers to help identify lists 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. Next, I'm going to go to Ms. McCloud.
▶ 0:35:01Your written testimony described the use of artificial intelligence to optimize claim processing, improve risk assessment, and drive operational effic- What are some of the examples of how you're using this technology? Auto adjudication is one of the the first ways that we've been using AI.
▶ 0:35:24This 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.
▶ 0:35:45Employers, 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.
▶ 0:36:03We get about 4 to 5 million documents a year, and through auto indexing, we're able Our initial estimates is that we 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 chat BWC policy bot.
▶ 0:36:25This 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 to them, so they can go to the source document.
▶ 0:36:47This is If we can scale this enterprise-wide, we expect to save about 20,000 hours We have something called data chat, which allows our staff to ask natural language questions, but it puts them into the structured query language.
▶ 0:37:03It improves access to insights and saving about 500 hours a year is our We, of course, the 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 boost productivity in Word, Excel, PowerPoint, Outlook, Teams.
▶ 0:37:30It helps users generate content, summarize automated tasks, and collaborate more efficiently by using AI in their That's great. It sounds like a very positive use of AI. We're glad to see state government adopting that.
▶ 0:37:44And as a former state legislator myself, and somebody who worked at our our state Department of Labor and Industry, one of the challenges we found in our 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?
▶ 0:38:14The 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 puts guardrails, especially on generative AI, but we have a statewide AI governance committee. Agencies must follow a formal process for identifying, documenting, reviewing, and they approve all AI use cases.
▶ 0:38:41AI solutions must align with the AI core principles for Ohio, which is fairness, accountability, security, transparency, and ethics. Great. Thank you. Appreciate that insight into what's going on in Ohio. Next, I'll go to Ranking Member Omar for her questions. Since the '90s, more states have been enacting aggressive reforms to workers' compensation programs.
▶ 0:39:11Mr. Gotfry, 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 Thank you for the question.
▶ 0:39:38Um, generally, I think what we've seen with state workers' compensation systems and I've seen it through my work with the is that the best practices that we can have amongst agencies is really helpful to determine how to provide care.
▶ 0:39:52But I think the other thing that we've seen is through the data some of it coming from the worker 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 [clears throat] a policy perspective is that when injured workers are not allowed to select their own physician there becomes distrust within that system.
▶ 0:40:21Doctors 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.
▶ 0:40:50So 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 with someone that the worker will trust. That's the best outcome for a workers compensation system.
▶ 0:41:07And in your experience as director and we talk a lot about the sources of waste fraud and But if 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?
▶ 0:41:26I think what we've seen over time especially as we look at like the opioid crisis that we had in the United States over prescribing 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 want to say that providers overall because the vast majority of providers are you know the the doctors and the physician assistants and nurse practitioners that we all use and rely upon.
▶ 0:41:54But we also heard Mr. 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 Thank you. Make sure we prosecuted that.
▶ 0:42:24Thank Mr. Johnson your company Sedgwick has been repeatedly fined and settled claims with states. In California [snorts] 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.
▶ 0:42:53the 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.
▶ 0:43:16Why is Sedgwick so frequently cited for failing to provide adequate care for their Thank you for the question ranking member Omar. I don't know the specifics of those 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 with 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.
▶ 0:43:44Those cases that may have been had other extenuating circumstances I can't comment on those certainly could follow back 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 that are interacting with injured workers that are learning about their personal lives that are understanding what their injuries have how they've taken place what their goals are and then ultimately are trying to use our systems our data our
▶ 0:44:14history 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 them well and return to work. That story repeats itself over and over again millions of times for us over times for us every year. So those individual cases I can get some comments back to you on but that's not the overall experience of our organization I appreciate your answer the the record reflects otherwise.
▶ 0:44:45I have a unanimous consent request to enter into the record. Without objection. And ex oh That's not I know but there's no time for unanimous consent request. But I thought it was for the record or Yes I would like to read what I want to submit into the record.
▶ 0:45:04Okay. Okay. An exchange of three letters between ranking member Scott and myself and the Department of Labor about the Department's over 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 911 911 health watch to Sedgwick's managed care advisors about poor service to survivors of the 911 World Trade Center disaster.
▶ 0:45:34An excerpt from a decision by the workers compensation appeals board of the state of California referring to what the board calls Sedgwick's disregard of 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 1.5 million to settle California comp violation.
▶ 0:46:05Thank you. Next we'll go to Mr. Walberg chairman of the full committee. Thank you Mr. Chairman and thanks to the panel for being here. Let me follow up Mr. Johnson I believe a crucial sign of successful workers compensation is a high rate of quickly returning workers to the the workplace.
▶ 0:46:24That shows that they've received a timely effective care and these programs then 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 to better return to work outcomes for injured workers? Thank you for the question chairman Walberg.
▶ 0:46:53The the the crux of returning to work is a 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 injured worker and ultimately coordinate those activities with managed care providers and also the treating providers in the in the field.
▶ 0:47:20And once they have that coordination and and plan and once they understand what the 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 and productive action in in society. We we think that several things can happen.
▶ 0:47:41Preferred 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 Get them back to work. 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.
▶ 0:48:09One 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 going to 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.
▶ 0:48:28Okay. Thank you. Mr. 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 What would a more flexible telemedicine policy look like? And secondly what are the limitations in that we have to consider?
▶ 0:48:58Thank you 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 provide care. For our patient population several several of our patients all of our patients have to be renewed annually. And and that is currently requiring a face-to-face visit.
▶ 0:49:23Like I said earlier for some of these patients with the shortage of physicians especially in rural areas there's a lot of transportation or time travel to the physician and for some of our patients they're very sick and it 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 the meeting that they need to continue on the program.
▶ 0:49:50And uh some of the limitations are telemedicine's not going to work for every visit because if the patient's health condition is declining, there will always be a time when clinician is 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 convenience uh for these patients.
▶ 0:50:14Good option in the in the in the coordination of care. Thank you.
▶ 0:50:19Uh Ms. McCloud, um how are managed care organizations maintaining the quality of participating care providers? Cuz we want the providers to be Thank you. Through the chair to Chairman Well, they must uh demonstrate a range.
▶ 0:50:37So, our 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 273,000 new claims each year. At that time, we had about 6,900 BWC certified providers in the system.
▶ 0:51:04Since 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 and requirements that BWC
▶ 0:51:34provides. 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 it is 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. If they meet the qualifications and all the rest. Exactly. That's exactly right.
▶ 0:51:56But, 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.
▶ 0:52:05Okay. Okay. Thank you. My time is Thank you. Next, we'll go to Mr. Mesmer from Indiana. Thank you, Mr. Chairman, and thank you, witnesses, for being here today. Uh the Federal Employees Compensation Act, or FECA, has not undergone a comprehensive modernization since 1974, even though state workers' compensation compensation systems have evolved significantly over the last 50 years. Mr.
▶ 0:52:28Johnson, as Congress evaluates potential updates to FECA, what reforms would help improve coordination of care and recovery outcomes for injured federal workers? I I think the the biggest thing that could be improved in the FECA environment is the is the provider arrangement. A network of providers that again are the most effective in treating workers' compensation injuries.
▶ 0:52:55Also, adjustments in the fees is a possibility, hopefully, that 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 and our networks across the country produce those best outcomes that we talked about.
▶ 0:53:17We 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 FECA in the FECA environment, also. We think that's the main driver that would be that we'd be a proponent for.
▶ 0:53:41There are other, obviously, changes to FECA that are on the table that I'm not necessarily an expert in, but but the one that drives the most, we believe, is on the provider side. Okay. Thank you. Ms. McCloud, in your written testimony, you credit the adoption of managed care organizations as a fundamental fundamental element of the success of Ohio's workers' compensation workers' compensation program.
▶ 0:54:01Similarly, in my home 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. Uh if we modernize FECA based on states like Indiana and Ohio, what would the overall impact of using managed care networks with federal workers' compensation be?
▶ 0:54:24thank you. Through the chair to Vice Chair Mesmer. Um the the impact for Ohio, again, what we've seen partnering with MCOs helps 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.
▶ 0:54:42Between 1998 and 2025, we've seen our file lag reduced from 30 days to 17 days, determination lag reduced by at least a day and a half, with our overall lag reducing about 2 weeks. Uh we've also again, as I said, seen our number of providers grow substantially. It's um it's going to be important that the MCOs meet the geographical needs, including rural areas, but our MCOs in Ohio have made extra efforts to do that. Okay.
▶ 0:55:12Thank you. What potential consequences should Congress be aware of when considering whether federal workers' compensation programs should use a managed care model? Uh clinical guidelines that promote consistent evidence-based uh decisions, reduce variability in case outcomes. Um because a lot of communication because MCOs can sometimes add complexity. There's a sometimes a who's on first for the injured worker of who am I dealing with? Am I dealing with the managed care organization?
▶ 0:55:42Am I dealing with uh the federal employee. Communication monitoring. We have a whole division dedicated uh CPM, contract performance monitoring, that monitors our contract our contract with our MCOs uh with appendices probably about four four to six inches uh on any given year. We're very proscriptive and prescriptive in what our MCOs can do. They work just for us.
▶ 0:56:08And then, of course, quality-focused incentives are going to be necessary to manage the added burden. Okay. What metrics does the Ohio Bureau of Workers' Workers' Compensation use to measure performance of managed care organizations? And how can that model be used for federal legislation? Uh the the metrics that we use, there's um 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.
▶ 0:56:38We're down to seven MCOs because of again, the the stringency and the prescriptive and proscriptive. But, um we measure through a combination of administrative metrics. Uh 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, uh while sufficient insufficient performance can result in financial set-offs. And we have implemented those.
▶ 0:57:07Uh we have also uh this comes up in our we certify all the MCOs about every 2 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. Uh the the report card helps, I think, a lot with the transparency for Ohio employers as they're selecting MCO
▶ 0:57:30Okay. Thank you. And I yield back my time. Great. Thank you. Next, we'll go to ranking member of the full committee, Mr. Scott from Virginia.
▶ 0:57:39Thank you, Mr. Mr. Speaker uh Mr. Um Mr. Godfrey, if you're an employee uh and get hurt on the job, you get lost wages, medical um medical costs, and a disability if you're disabled. Which of those would you get if you're misclassified as an independent contractor? As an independent contractor, you would not qualify for workers' compensation unless you pay for insurance on your So, you wouldn't get any of those as an independent contractor.
▶ 0:58:09Uh you tell us the um research and the relationship between private equity investment in health care and quality of Uh can you say something about that? Sure. Uh Overall, private equity involvement in managed care and workers' compensation has been problematic for injured and ill workers. Um it it leads to cost shifting.
▶ 0:58:33Um one of the things that uh I have uh witnessed is that uh private equity can come into a workers' compensation system, uh basically be paid to take on high-risk uh or high-dollar cases, and then we know that because they received that money, they are going to try to keep costs under the dollar value of what they basically were paid to take on the the liability for that case.
▶ 0:58:59And as you can imagine, that's going to lead to denials, delays, um cuts in in uh benefits to the worker, and ultimately, that shifts to taxpayers. And has research uh shown Um I I think the investment uh or the involvement of private equity is somewhat new, so the data is not clear. Um but it is an area that we are looking at very carefully.
▶ 0:59:23And what does cost shift mean? 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.
▶ 0:59:47Who sets the the who selects the doctors that are able to handle um workers comp cases on the federal level? On the federal level for the FECA program, uh uh 5 U.S.C. 8103A says that the injured worker gets to choose their own physician. Okay. And is there a fee schedule? Yes, there is a fee schedule. Who sets the fee schedule?
▶ 1:00:14The fee schedule is set annually by the uh United States Department of Labor. Um it is done in conjunction with other entities to make sure that it is a competitive fee schedule, which is has cost savings, uh but also is competitive to keep doctors within the system.
▶ 1:00:29And are the fees set at a rate where doctors actually want to participate? You have mentioned the value of permitting schedule awards to be issued concurrently with wage compensation with wage loss compensation. What did you mean by that and can it take place now?
▶ 1:00:56I have concerns with the current uh 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, your 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.
▶ 1:01:22Uh it is pretty well settled in workers compensation that those are two separate elements of damages uh under the current administration of the FECA program, uh they are not paid um they're only paid uh consecutively. Uh so that if you want to receive a schedule award, you have to stop receipt of wage replacement benefits. I think that is an improper uh administration of the law and I would urge Congress to take a look at that.
▶ 1:01:51is that does that apply to um longshore cases, too? No, I believe that's the FECA program specifically. Well, so do you you think it's a violation of the law so they just sort of changed the practice? I think that the uh regulations and uh procedures of the Office of Workers' Compensation uh should be reviewed by Congress to make sure that people are paid schedule awards that they're entitled to under the law. Okay. Thank you, Mr. Chairman. Thank you.
▶ 1:02:22Next, we're going to go to Mr. Grothman from Wisconsin. You can You can have a moment to get
▶ 1:02:31Right on time, so that's good. We like it. We'll start with Mr. We'll start with We'll start with Mr. Howe here. Uh 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? Uh thank you for the question.
▶ 1:02:51A critical metrics that we should use is the time we identify a potential patient to the time they receive care and going through the approval process. Uh this is a metric that uh we want to make sure is as fast as possible. The bill that uh we are discussing today would be a critical uh positive opportunity to shorten that time.
▶ 1:03:17Access 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 that determination. So, I feel uh a priority metric is the timing from identification to delivery of care. Thanks. What enhancements could we make to the claims process to better support the claimants and improve their experience?
▶ 1:03:44Yeah, 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 the disease or the illness that you're suffering. So, there's there's a lot of paperwork and a lot of assessment that's done at that time.
▶ 1:04:09The 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 is key to that and and I firmly believe that this bill will help to do that. Okay. We'll switch to Mr. Johnson here. Uh your written testimony highlights several applications of artificial intelligence in workers comp. However, you also recognize the need for proper control and safeguards.
▶ 1:04:39How can we make sure the balance how how can we balance an effective use of AI while also making sure these programs safeguard patient privacy? Thank you for the question, Representative.
▶ 1:04:52I In our view, the use of AI has been very powerful in the claims management arena, mainly in assisting the claims examiner in helping to promptly 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.
▶ 1:05:22There should be a human that evaluates the ultimate that evaluates the the case that is before them and then ultimately manages that case throughout its continuum using the AI tools to supplement their their abilities as as a 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.
▶ 1:05:51We think that that oversight and that constant monitoring of the AI that's involved in claims management is of 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 um 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.
▶ 1:06:21Can you can you give us any specific examples of success stories of patient privacy safeguards being implemented uh as part of AI usage? I I think keeping those within the federal environment that are already of the utmost um cybersecurity requirements is key in in any one of these the discussions and in any one of these rollouts.
▶ 1:06:42Um the the fact that we've got, you know, we do constant um uh 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 um increases in scope, if you will, given the fact that we're bringing in now an an additional party in um in weighing in on the ultimate management of a claim.
▶ 1:07:12Ms. McCloud, I'm going to ask you kind of a broad question. Uh if I go back home and ask people what do they think about the uh um the workers compensation program, uh they always have anecdotal evidence of of the program being abused. Could you comment on that on a scale of 0 to 10?
▶ 1:07:30Where do you think we are as far as putting together a a good uh workers comp program without people It seems the 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, could you comment on where you think we are right now as far as putting together a successful program? Uh thank you through the chair uh Representative. Um I can speak to Ohio and Ohio's experience is is not that.
▶ 1:07:59We have a robust fraud program, of course, both that investigates employers as well as injured workers, but we do not see um we have identified a lot of savings, but we do not see the level of fraud either in injured workers or employer efforts uh that certainly we've seen in the past just by uh getting injured workers back to work um has has helped quite a bit as well as uh
▶ 1:08:29our work with the managed care Thank you. Next, we'll go to Mr. Fine from Florida. 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.
▶ 1:08:51I 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 you're getting workers compensation, right?
▶ 1:09:14So, you're compensated for not being able to work, but then when you wouldn't be able to work anyway, you're still being compensated for not being able to work. The idea that people that are that are retired or continuing to get workers' comp is simply offensive, I think, to the to the American people. So, a few questions. Uh Mr. Johnson, as you state in your written testimony, government-funded programs should have integrity and prevent fraud.
▶ 1:09:39How does the use of predictive analytics, um which frankly I was working on 20 years ago, enhance fraud prevention and overall program quality? Thank you for the question, Representative. Well, first of all, the we leverage predictive analytics to identify risk, not to presume wrongdoing in in any way. So, we're trying to understand the uh the patterns that are involved in any one particular workers' compensation case and patterns that patterns that may be anomalies when compared to larger sources of data.
▶ 1:10:08That's one of the benefits of organizations that manage uh multi-millions 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 uh um a claimant side, but also on the provider side.
▶ 1:10:29So, we look for anomalies in the treatment patterns, the uh prescribing of medications, the utilization of uh 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.
▶ 1:10:48It's not the system ultimately making that decision, but the use of all that data, artificial intelligence, 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
▶ 1:11:02Okay. So, so what barriers follow up for you? What barriers have states and your own organization encountered when you're trying to implement this technology? But most of the time the states are concerned about over overdoing it, over reporting. And so, you don't want to get a situation where um you know, they they want to see legitimate cases. They have certain amount of uh resources and power to be able to review cases themselves when we're turning in packages for them to examine.
▶ 1:11:28And so, they they get most of the time they're concerned about the fact that uh that there's a certain standard that needs to be met before those packages turned in. But most of the time people can understand that we're legitimately looking for these patterns and having an having a notion about whether or not there's something untoward that's going on there. Okay. Um shifting focus, I've got a 2 minutes left, Ms. McCloud, a question for you.
▶ 1:11:50Your 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 are the Ohio Bureau of Workers' Compensation continuing to make to improve its efficiency in serving injured workers? Thank you for the question through the chair to the representative.
▶ 1:12:10Um tr- 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 specialized team for occurrence needs. We've spent a lot of time when the pandemic hit, we put together a COVID-19 uh claim group to make sure that they got the special attention that they need.
▶ 1:12:36We do the same for claims that involve more than three injuries, uh 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.
▶ 1:12:59Uh I've talked a little bit about auto automatic claims processing and uh working a lot in the vocational rehab with what we call it's 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, the longer you're off work.
▶ 1:13:23So, getting people into a job that where they can be successful and as Governor DeWine would say, live up to their God-given potential and be able to re-enter the workforce. Um we work hard on that with our MCOs. Well, thank you. Thanks for working on this. Uh it's an important issue and thanks for being here today. Mr. Chairman, I yield back. Thank you. Next, we'll go to Ms. McBath.
▶ 1:13:56Thank you, Mr. Chair. Thank you very, very much. Um Uh thank you, Chairman McKenzie, but also thank you to the uh the uh ranking member of the entire committee, Chairman Scott, and ranking member Omar, uh for allowing me to sit in today. Thank you so much for letting me wave on.
▶ 1:14:17And thank you to our witnesses today for uh convening this important discussion on how we can better support our public servants uh who have given years of lives and 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.
▶ 1:14:46However, 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 life-saving care. It is why I am proud to partner with my colleague across the aisle, uh my Georgia delegation uh member, Congress Congressman Rick Allen.
▶ 1:15:11Uh we have both partnered on this legislation that would cut the red tape and improve access for our public servants. The Health Care for Energy Workers Act would modernize an outdated provision that unnecessarily restricts access to care for those who live in health care ensuring that our public servants have access to the care that they need what they need when they truly need it.
▶ 1:15:37Georgia 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.
▶ 1:16:05And for the people living in Webster, Montgomery, or Chattahoochee County, the provider shortage forces six pat- 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 isn't 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.
▶ 1:16:35But 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 running up the tally on hours spent on the road so they can get the life-saving care and routine treatments that they Like our neighbor down in Coweta County, who after years working as a pipefitter at a nuclear site, settled down in Sharpsburg, Georgia as he battles cancer and pneumo- pneumoco-
▶ 1:17:06is it uh excuse me, but it's a severe and irreversible lung condition caused by inhaling toxic dust. The current law enforces him to regularly drive over 6 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 shortage shortages that patients are facing on the ground.
▶ 1:17:35This 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 with their next physician's visit, more time to heal in the comfort of their own home their own home, and more time with their families and their communities. Mr.
▶ 1:18:03Howe, 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? Yes, thank you for this very important question. You mentioned pneumoconiosis. Uh we do see a lot of respiratory illness uh specifically to silicosis and asbestosis, two forms of pneumoconiosis.
▶ 1:18:28We 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 uh 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 also was cancer.
▶ 1:18:56There are 22 forms of cancer associated with exposures to these toxic uh materials and radiation. And patients who are in the end stages of the cancer, earlier stages of the cancer, delaying care for them even by a week, a month, or 2 months to get a physician's appointment would delay the entire process to getting approved. Some of these people don't have the gift of time.
▶ 1:19:22And 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 1 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 1 day to provide care and comfort for that support. You also mentioned transportation.
▶ 1:19:50A 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 driving with an oxygen tank for 6 hours and being fearful that that tank could run out. Uh 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.
▶ 1:20:20And we thank you so much for bringing this bill to to life. Well, thank you so much. I'm out of time, but thank you for caring for our energy patients. Thank you. I yield. Thank you. Next, we'll turn to Mr. Allen from Georgia. Well, not to repeat uh this uh subject, but I want to thank you, Chair McKenzie, for allowing me to wave on into this hearing and I thank the witnesses here for testifying.
▶ 1:20:46Uh and I want to thank Nuclear Care Partners for its support of HR uh 4122, the Healthcare for Energy Workers Act, which I introduced alongside Representative uh uh Bath uh of Georgia.
▶ 1:21:00Uh this legislation uh is 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 healthcare under this Department of Labor program.
▶ 1:21:23Uh Georgia's 12th District is home uh to thousands of energy workers employed at Plant Vogal and Savannah River Site, uh many of whom uh qualify for the for their healthcare needs.
▶ 1:21:37However, those who live in rural areas, as uh Representative McBath mentioned, are often hours from the nearest uh highlighting the need for greater flexibility to ensure these beneficiaries receive the care that they Uh this legislation addresses an unfortunate reality that there is a critical shortage of eligible care providers in many parts of this country.
▶ 1:22:03Uh and by cutting unnecessary red tape and improving access to care for energy workers in Georgia and nationwide, in addition to allowing uh Mr. Allen, 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 uh you know, these these providers to actually uh uh help folks
▶ 1:22:33in these rural areas? Yes, thank you for the question. It will uh reduce delays by improving speed of access to the care providers. Like you said, getting uh care by a nurse practitioner or family a physician assistant in your local community will much will be faster.
▶ 1:22:53Uh it's going to reduce redundancies because certain situations now where a patient is 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 of services. So, that that's a not efficient. Most importantly is the savings of cost.
▶ 1:23:19Mhm. Our healthcare 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 cost by preventing patients from having to go to the hospital. The faster we get in the home, the better we can uh keep these patients healthier, keep them out of the hospital, and reduce costs to the system.
▶ 1:23:48Well, uh you know, the other thing we did through the Working Families Tax uh uh Act is uh provided additional resources for our rural hospitals. And uh what I've experienced with our rural hospitals, you know, the telemedicine program's been around it it started there in my district at Augusta University. And it's been around since 1960. It evolved in in COVID, obviously, heavily.
▶ 1:24:15And uh and in fact, now you can walk into a hospital and you can get within 60 seconds a physician uh from Augusta to look at the issue and and provide the uh care. And so, I think that is a big plus uh that we need to uh which which would be included in HR 4122 to allow uh these uh nurse practitioners and others to get immediate care for our our patients.
▶ 1:24:46Uh in your written testimony, it calls for passage uh which would allow nurse practitioners and physicians assistants, which we talked about, to order care for patients in the Energy Workers program. Uh are there other federal healthcare programs already allowing nurse practitioners and physicians assistants to order care? Yes, currently both the VA and the CMA CMS systems allow nurse practitioners and physician assistants to provide care and write for care.
▶ 1:25:14And why has the Energy Workers program not adopted this practice? I I can't speak for why the program hasn't adopted the practice. I can speak uh 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. So, that's why I'm making this bill this bill is so important.
▶ 1:25:37we need the legislation.
▶ 1:25:38the legislation to make the change uh to get us equal to both the VA and the CMS systems. Okay, great. Thank you. I'm yield back. I'm out of time. Thank you, Mr. Chairman McKenzie, for allowing me to wave on. Thank Thank you to the Thank you. That concludes member questioning. I appreciate uh all of the testifiers for their responses. We will head to closing remarks and I'll recognize the ranking member for her closing statement. Thank you, Mr.
▶ 1:26:05Chairman, 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.
▶ 1:26:26Whether it is a postal worker delivering mail or a firefighter uh battling wildfires on public land, these workers perform essential duties every single 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.
▶ 1:26:53Programs like FECA provide stability in those moments, making sure that injured workers can access medical care, receive wage replacement, and when possible, return to work once they are recovered. At the same time, these laws are quite old. FECA is mark is more than a century old and the Energy Workers program recently marked its 25th anniversary.
▶ 1:27:19So, 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 that every protection that injured workers rely on.
▶ 1:27:49If 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. I yield back. 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.
▶ 1:28:16By cutting through red tape, simplifying paperwork, and embracing the digital solutions, we can reduce administrative burdens and ensure injured workers receive the compensation they deserve without any unnecessary delays. As today's witnesses have highlighted, there is also a clear need to increase access to care for program claimants.
▶ 1:28:36Fortunately, there are bipartisan solutions that address these problems, some of which were discussed We must advance policies that reduce and prevent abuse of the system as well and provide greater access to care for critical uh 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 uh to join us today. And without objection, there's no further business before the committee and the subcommittee stands adjourned.