Medical Support Panel (MSP)

The aim of the MSP is to leverage specialist medical expertise to improve health outcomes and the experience for injured workers and employers, while managing scheme sustainability.  

The MSP is an in-house service of icare consisting of experienced medical specialists who apply evidence based, best-practice and reasonably necessary principles when advising case managers. This enhances the information available to case managers making decisions on medical aspects of claims.    

By reviewing case information, the MSP medical specialists can make treatment and medical causation recommendations quickly, in an average of five days compared to six weeks before the commencement of the panel.   

Within 24 hours of receiving the MSP recommendation, case managers are to give due regard to this in the context of other information related to the claim and relevant legislation. There is an expectation that the recommendation will be supported and implementation will begin within this timeframe, unless there is other opposing information.  

    Frequently Asked Questions

  • Why did we establish the MSP?

    A 2016 icare review of Independent Medical Examinations (IMEs) indicated that a significant number of IME services conducted between 2013 and 2015 resulted in acceptance of treatment or no change to the direction of the claim.    

    This means workers were waiting on average six weeks for treatment to be approved that could have been approved without delay. This was, in turn, delaying workers’ recovery and return to work.

    The Medical Support Panel is one way icare is bringing the focus of workers compensation to the person rather than the process.   

  • What kind of cases does the MSP review?

    Types of cases that can be referred to the MSP include:    

    Treatment review

    For cases where there are questions around whether treatment requests are reasonably necessary.       

    Medical causation review

    For cases where there are questions or concerns relating to (but not limited to):  

    • the mechanism of the injury  
    • ongoing medical causation  
    • diagnosis  
    • aggravation, or recurrence, of injury  
    • resolution of an employment related condition  
    • secondary medical conditions  
    • pre-existing medical conditions.    

    Treatment/medical causation review 

    Treatment and medical causation may also be reviewed together.     

    Independent Medical Examination (IME) report review 

    For cases where clarification regarding an aspect of an IME report is sought, or where the case manager believes a supplementary IME Report may be required.     

    Medical Strategy review 

    For cases where assistance is required in relation to a medical strategy on the case. For example, exhaustive treatment doesn’t seem to be working for the worker, discussions with treatment providers, assistance on how to approach pre-existing or co-existing conditions.    

    Medication review 

    For review of cases where a review of medication is requested. Requests may include to:  

    • discuss medication combinations/dosages and alternative options with the treating doctor  
    • obtain a list of injury related medications  
    • clarify the purpose of particular medications.     

    Medication review referrals should only be referred to the MSP within 12 months of the date of injury. Cases greater than 12 months since the date of injury should only be sent to the MSP for requests to:  

    • obtain a list of injury related medications  
    • clarify the purpose of particular medications.   
  • What information does the MSP consider when making recommendations?

    The MSP will provide recommendations to scheme agents to enable them to determine whether medical investigations and health interventions are evidence based, best practice and reasonably necessary and whether medical causation exists.    

    Additionally, where the scheme agent is unsure how to manage a medical aspect of a claim the MSP may review the relevant medical information and provide potential strategies and options to assist. Where required, the MSP will consult with relevant parties to help facilitate a resolution or obtain consensus to an alternate pathway.    

    The MSP specialists review and consider relevant case information available. This could include (but is not limited to):  

    • Certificate of Capacity   
    • Treatment request/s   
    • Recent medical and/or provider reports relating to treatment, medical causation etc.   
    • Medical investigation reports   
    • Independent Medical Examination/injury management Consultant/independent consultant reports   
    • Factual investigation documents   
    • Surveillance reports   
    • Rehabilitation reports   
    • Previous/current position descriptions  
    • Claim forms.   

    As an in-house icare service, MSP specialists, like case managers, may contact workers by phone as well as a worker’s nominated treating doctor and other health professionals involved in their care.     

    Employers can provide any additional relevant information to their case manager for the MSP to review.        

  • What types of recommendations does the MSP provide?

    Support 

    In cases where the MSP recommendation is to support the approval of medical investigations or medical causation.    

    New pathway 

    In cases where the MSP recommendation is a new pathway, such as alternative treatment, after discussion and consensus with the worker and other relevant stakeholders (including the nominated treating doctor – usually a GP – and case manager).    

    IME referral 

    In cases where the MSP recommendation is for the case to be referred to an Independent Medical Examination.     

    Recommendations to refer a case to an IME occur when the available medical information is inadequate, unavailable or inconsistent.    

    If this recommendation is provided, the MSP specialist will, in consultation with the case manager, identify the IME specialty type and propose a summary of the issue and specific, objective and relevant questions to be answered in the IME.    

    Medical case strategy 

    In cases where the MSP provides ongoing, or further, direction to the case manager regarding the claim.    

    Medication review 

    In cases where the MSP provides guidance to case managers regarding the pharma-logical treatment.    

    What should I do if I have questions or concerns about an MSP recommendation?  

    If you have concerns or questions about the MSP recommendation you can speak to your case manager for more information. Case managers can liaise with the MSP as required.  

  • Do MSP services impact premiums

    No, the MSP review of claims and recommendations are not premium impacting.

    While MSP reviews and recommendations will be invoiced to the claim, this is for recording and tracking purposes only. These charges are not included when premiums are calculated. 

An innovative approach to treatment for injured workers

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