Proposed amendments to give the Personal Injury Commission power to control service providers

The proposed amendments to the Motor Accidents Injuries Act, Workers Compensation Act 1987, and the Workplace Injury Management and Workers Compensation Act 1998 would give the Personal Injury Commission (PIC) the power to exclude service providers who are overservicing and overcharging.

Key Point:

  • The Personal Injury Commission is given the power to obtain data, give directions to service providers and to enforce those directions with penalties for non-compliance.
The Motor Accidents and Workers Compensation Legislation Amendment Bill 2021 (Bill) was introduced into the Legislative Assembly on 9 June 2021 by the Hon. Victor Dominello, Minister for Customer Service. The bill’s objectives include improving access to compensation entitlements for people injured in motor vehicle accidents and their dependants. It also aims to improve customer service, scheme efficiency, fairness and equity.

A review of the PIC’s expenditure on medical and related costs showed a 47% increase in expenditure between 2016 and 2019. The current level is over $1 billion a year. There was evidence of over servicing and overcharging by some healthcare providers. Further, it was found there was limited availability of healthcare data which impacted PIC’s ability to monitor the scheme and health provider behaviours. The purpose of the legislative amendments is to equip the PIC with the regulatory tools to ensure treatment and other services provided to the injured workers and road users are appropriate, timely, cost effective, and contribute directly to improving outcomes.

The proposed amendments include:

a) It would be a condition of an insurer's licence not to engage, approve, or pay a service provider for an excluded service. There is currently no section to exclude providers. Guidelines on operation will need to be issued.

b) Giving the PIC the power to issue directions to service providers who are not providing services in accordance with the regulations.

c) Giving the PIC the power to direct providers to provide data and information. This gives the PIC better ability to monitor claims experience, quality and value of those services.

d) It could be an offence for a provider to not comply with a direction to provide data.  Maximum penalties for non-compliance of 500 penalty units for a corporation or 100 penalty units for individuals.

e) The amendments would provide a right for the providers to apply to the NSW Civil and Administrative Tribunal for a review, where a direction from the PIC restricts the provider from delivering services in the schemes.

Currently, the PIC can refer concerns about providers' professional practice to their professional bodies or the Health Care Complaints Commission but it is unable to prevent service providers from delivering treatment and other services in a manner inconsistent with the workers compensation or CTP legislation and its objectives.

The aim of these amendments is to promote the safety, transparency, affordability and sustainability of the workers compensation and CTP schemes.

Post by Hicksons Special Counsel, Laura D'Alessandri, Solicitor, Sandra Aziz, and Paralegal, Ninorta Gabriel.

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