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Government Performance Results Act of 1993 (GPRA)
Under the Government Performance Results Act, or GPRA, the Division of Coal
Mine Workers' Compensation has undertaken to improve its performance in several
measurable areas while continuing its ongoing services to claimants and beneficiaries.
After successfully targeting improved dispute resolution outcomes, the Program adopted a new focus in 2004, to reduce the average number of days required to render a decision on a claim for benefits.
The Program defines this measure as the time from receipt of a claim to the issuance of a Proposed Decision and Order. Because some claims involve extensive development of medical and/or employment issues, because the regulations have time allowances that cannot be shortened, and because the number of claims impacts Program resources, average processing time may fluctuate from year to year. From 2004 to 2008, the average processing time declined from 320 to 205 days, a reduction of 36%, far exceeding our goal of 220 days.
In 2007, DCMWC adopted the National Health Expenditure Projection as a guide against which the Program would measure its medical treatment costs with a goal of keeping the average cost per miner below the level of inflation predicted by the NHEP.
Although the NHEP appeared to be a good model for the Program’s average expenditure growth during the study period and base year, recent experience has shown that the Program’s per capita expenditures, while still below the NHEP’s long-range projections, are more volatile on an annual basis than the Projection. Consequently, the program did not meet its goal for 2008.
While the Program considers alternative indices, it is taking concrete steps to reduce costs, including closer review of in-patient bills and adjustments in pharmacy reimbursements.
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