HR 6087: A Commonsense Remedy?

Improving Access to Care for Injured Federal Workers

HR 6087, Improving Access to Workers Compensation for Injured Federal Employees Act of 2022, was passed by the House in June 2022 and stalled in the Senate. Similar measures, S 131/HR 618, were reintroduced during the 2023 118th Congress in a bipartisan manner (American Association of Nurse Practitioners, 2023). The bills add language to the Federal Workers’ Compensation Act, expanding the definition of qualified provider to include nurse practitioners (NPs) and physician assistants (PAs). These bills allow NPs and PAs to sign their own medical reports and provide evidence to support a workers’ compensation claim (Improving Access to Workers’ Compensation, 2022).

In a letter to Senators Peters and Portman supporting HR 6087, George Townsend, President of the Workers’ Injury Law & Advocacy Group (Townsend, 2022), explained that many federal employees are treated by NPs and PAs, yet reports with NP or PA signatures are not accepted. This results in delayed authorizations for diagnostic testing, treatments, and referrals to specialists. Delayed care adversely affects the eventual medical outcome and contributes to increased lost time and wage loss payments. Out-of-work federal workers who have had their claims denied may have medical insurance benefits terminated. Most personal health insurance carriers will not cover a work-related medical problem, even if the workers’ compensation claim is denied (Townsend, 2022).

Shortages of primary care and medical specialists are expected to worsen (Robeznicks, 2022). A limited number of physicians choose to accept federal injured workers. About one third of federal employees live and work in remote rural areas where this problem is compounded (Kness, 2020). The passage of S.131/HR 618 ensures increased access to providers with the training, education, and experience required to treat injured federal employees. According to the Congressional Budget Office (CBO), this legislation may reduce lost time and is considered budget-neutral (CBO, 2022).

HR 6087 and S. 131/HR618 support patient choice by enabling federal employees to maintain trusted healthcare relationships with their clinicians of choice. When evaluating consumer choice and safety concerns, the Federal Trade Commission (FTC) concluded, based on “substantial evidence and experience,” that advance practice nurses are safe and effective as independent providers when practicing within the scope of their training, licensure, certification, and education (Gilman et al., 2014). The Institute of Medicine (IOM) Report on the Future of Nursing recommended nurses’ roles expand to include those appropriate to the level of their training and education “to advance improvements in America’s increasingly complex health system” (IOM, 2011).

The American Association of Nursing (ANA) cited passage of HR 6087 as one of the highest priorities for nursing in 2023 (Bean, 2022). HR 6087 and S.131/HR 618 represent commonsensical, budget-conscience solutions to one of the problems with the Federal Workers’ Compensation Act. Occupational health nurses have a rare opportunity to improve access to care by urging Congress to support this landmark legislation.