Division of Coal Mine Workers' Compensation (DCMWC)
Black Lung Program Performance Results
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 2009, the average processing time declined from 320 to 201 days, a reduction of 37%, 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. Nevertheless, while the Program did not meet its goal in the first year, measures taken in 2009, including closer review of in-patient bills and adjustments in pharmacy reimbursements, enabled the Program to meet the goal for FY 2009 with an increase of 2.76% as against the NHEP projection of 4.6%. Even as the Program considers alternative indices, it continues to take concrete steps to reduce costs without reducing services.
BLACK LUNG GPRA PERFORMANCE – Average Processing Time to Render a Decision on Black Lung Claims for Benefits