Today, the Workforce Protections Subcommittee held a hearing examining theFederal Employees’ Compensation Act (FECA). The FECA program provides benefits to federal government employees who sustain an injury or illness in the performance of duty anywhere in the world.
“The need for reforming FECA has long been recognized by the presidential administrations from both parties, with the Clinton, George W. Bush, Obama, and first Trump administrations making reform proposals. While these administrations have differed on many matters, they agreed on many reforms to benefit FECA recipients. Such reforms include making the wage-loss compensation level uniform for all beneficiaries, permitting physician assistants and nurse practitioners to approve claims for FECA benefits, and allowing [the Department of Labor] to communicate with the Social Security Administration to review claimants’ employment and wage information,” he said.
Witnesses also highlighted that the FECA program is also susceptible to waste, fraud, and abuse.
“Since [Fiscal Year] 2015, the Office of Inspector General (OIG) has opened more than 320 criminal investigations involving the FECA program. Our FECA investigations have resulted in the indictment and conviction of 322 individuals, including a significant number involving medical provider fraud, producing more than $1.7 billion in monetary results,” said Mr. Luiz Santos, Acting Inspector General at the U.S. Department of Labor.
“One of the great advantages of the FECA program is the right to choose your treating physician,” explained Mr. Scott Szymendera, with the Congressional Research Service at the U.S. Library of Congress. “However, there have been persistent complaints about FECA and the other [Office of Workers’ Compensation Programs’] programs that while you have the right to choose your treating physician, there isn’t one available for you to choose especially when you are outside of the Washington [D.C.] area or other metropolitan areas that have potentially a lot of federal employees. Expanding the pool of providers to include nurse practitioners and physician assistants could allow greater access to physicians. It also could bring certain non-traditional facilities such as urgent care clinics or medical clinics in retail stores into a greater role into providing care.”
Rep. Randy Fine (R-FL) brought up that while Congress is supportive of providing care to injured federal workers, the biggest threat to these programs is the high level of fraud. In his exchange with Ms. Tammy Hull,Inspector General at the U.S. Postal Service, she stated that there are hundreds of millions of dollars in fraud.
“So, this is hundreds of millions of dollars that is either being taken from a postal worker or someone else who actually has a problem that they need help with or that’s money that we’re borrowing from our grandkids to give to people who don’t need it,”Rep. Fine concluded.
Rep. Mark Messmer (R-IN) asked Ms. Hull about the U.S. Postal Service’s (USPS) costly worker’s compensation program: “Which cost-saving mechanisms can Congress authorize USPS to adopt so that their worker’s compensation program more closely mirrors private sector practices?”
“As part of that work we looked at how others were managing their costs in their workers’ compensation programs. What we saw were things like limitations on dollar amounts in duration of benefits, allowing settlements to reduce the ongoing costs, [and] employer-selected physicians rather than employee-selected physicians,” said Ms. Hull.
Rep. Mary Miller (R-IL) asked Mr. Santos about what oversight is being done to prevent claimant fraud. “Under the current FECA program, there have been instances of workers reporting an injury to collect disability benefits while they are subsequently found to be secretly working another strenuous job,” she explained.
Mr. Santos validated her concerns and explained how the program integrity unit and the data analytics they use help in this area. “Data really is the key to provide adequate and comprehensive oversight of these matters. The program integrity unit then refers those cases to my office, and then we take action and investigate,” he said.
Bottom line: Committee Republicans recognize that the status quo is not an option. Federal workers and taxpayers deserve a more efficient and effective program.
