Health care provider sues Dept. of Labor claiming under new rule "workers are still at risk of not getting timely access to medical care"

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Thursday, April 4, 2019
News 12 at 6 O'Clock

NORTH AUGUSTA, SC (WRDW/WAGT) -- The U.S. Department of Labor responded Tuesday to a lawsuit claiming former Savannah River Site and other government workers across the nation who became ill while working at SRS and other government sites might have to wait longer for care because of a federal rule change.

What was at stake was getting lifesaving care quickly. It was to the point that a large health care provider, Professional Care Management, filed an injunction March 19 to stop the ruling from taking effect.

Tuesday, Professional Care Management withdrew their injunction, meant to stop the rule from taking effect, saying "The DOL’s response to our petition for injunctive relief contained some clarifications to their proposed rule changes for pre-authorization of care. We are taking the DOL’s comments on good faith at this point and will proceed with the lawsuit.”

Professional Case Management says as currently written, the changes could cause workers to face significant delays in receiving the care they need.

"PCM is still proceeding with the lawsuit," Greg Austin, PCM president, said. "It was only the motion for injunctive relief that was withdrawn. The lawsuit is ongoing and workers are still at risk of not getting timely access to the medical care they need if the DOL rules as written go into effect on April 9. The DOL still has not changed the rules in writing, so their response is not binding at this point."

Many families could potentially be impacted.

90-year-old Dewey Booth needs around the clock care after diagnoses of leukemia, pulmonary fibrosis, and skin cancer.

"He had a little episode that put him in the hospital for a couple of days and the doctor said can't go home without health care,” Dewey’s son, Ronnie Booth, said.

More than 30 years of making a living for his family as a uniformed guard in safeguards and security for SRS cost him his health.

"What we knew could happen, but never thought would happen did happen, in terms of illness because of employment there,” said his son, Ronnie Booth.

In 2016, the U.S. Department of Labor wrote to Dewey, saying, "You are a DOE contractor with pulmonary fibrosis due to exposure to asbestos at a DOE facility.”

The Department of Labor also approved coverage of his medical expenses for three other illnesses resulting from his time at SRS. The Office of Workers Comp runs the program that pays for his caregivers, his nebulizer, and other medical bills.

“Within 48 to 72 hours of the doctor saying we need to do something, professional case management was able to step in, at our request, to do the background work and make it happen. And that is huge. We would have had a problem otherwise,” Ronnie said.

One of the largest providers, PCM Healthcare, sued the U.S. Department of Labor and Office of Workers Comp claiming under a new rule -- set to take effect April 9 -- that "new claimants for home healthcare may have to wait as much as 60 days for the care they need."

"That's kind of like saying I need an ER visit and then saying, ‘Take a number. I will see you in 3 months,’” Ronnie said. “They may not be here in 3 months."

“Given all that people gave over the years, I really think it's a small price to pay to be able to get a short turn around to get in-home health care,” Ronnie said.

The Department of Labor clarified that new rule, saying, "care will be paid for retroactive to the date the original claim was filed, and that (2) the pre-authorization process must be followed to obtain payment."

A spokesperson for the United States Dept. of Labor and Office of Workers Compensation told us: "As this matter is the subject of litigation, you should reach out to the Department of Justice for comment. The Department of Labor already filed the response (April 2) and as a result, the request for a preliminary injunction has been withdrawn and the PI hearing canceled."