HJ136: Virginia Retirement System; JLARC to study system for determining eligibility for disability claims.

HOUSE JOINT RESOLUTION NO. 136
Offered January 11, 2012
Prefiled January 11, 2012
Directing the Joint Legislative Audit and Review Commission to study the system for determining eligibility for disability claims under the Virginia Sickness and Disability Program administered by the Virginia Retirement System. Report.
Patron-- Anderson

Committee Referral Pending

WHEREAS, the Virginia Retirement System (VRS) exists to provide its members and their beneficiaries with benefits at retirement, or upon disability or death, and serves as an important source of security for state employees; and

WHEREAS, VRS administers the Virginia Sickness and Disability Program (VSDP) for state employees in addition to other state employee benefits and plans; and

WHEREAS, VSDP provides sick leave, family and personal leave, and short-term and long-term disability benefits for covered employees, spouses, and dependents; and

WHEREAS, it is important to ensure that the process for making a determination of eligibility under VSDP after a claim has been filed is based on sound medical grounds; and

WHEREAS, under a previous system, determinations of eligibility were made by Virginia physicians and health care professionals, but the current system provides for determinations of eligibility to be made by a third-party contractor; and

WHEREAS, a need exists to examine whether the current system adequately provides members with the proper coverage as contemplated by the General Assembly; now, therefore, be it

RESOLVED by the House of Delegates, the Senate concurring, That the Joint Legislative Audit and Review Commission be directed to study the system for determining eligibility for disability claims under the Virginia Sickness and Disability Program administered by the Virginia Retirement System.

In conducting its study, the Joint Legislative Audit and Review Commission shall (i) examine and compare the system operating when determinations of eligibility were made by Virginia physicians and health care professionals to the current system where the determinations are made by a third-party contractor, (ii) review the differences in the rates of approval and denial under the two systems, and (iii) review and compare the rate of appeals under the two systems and the decisions of hearing officers regarding such appeals.

Technical assistance shall be provided to the Joint Legislative Audit and Review Commission by the Virginia Retirement System. All agencies of the Commonwealth shall provide assistance to the Commission for this study, upon request.

The Joint Legislative Audit and Review Commission shall complete its meetings by November 30, 2012, and the Chairman shall submit to the Division of Legislative Automated Systems an executive summary of its findings and recommendations no later than the first day of the 2013 Regular Session of the General Assembly. The executive summary shall state whether the Commission intends to submit to the General Assembly and the Governor a report of its findings and recommendations for publication as a House or Senate document. The executive summary and report shall be submitted as provided in the procedures of the Division of Legislative Automated Systems for the processing of legislative documents and reports and shall be posted on the General Assembly's website.