This week at the Workers Compensation Roundtable on LinkedIn there are two still-active discussions from last week. One is in regards to when first aid crosses the line to workers compensation. Follow this topic here. The other asks about what to do when an injured employee says they are fine initially and then the problem worsens throughout the day. Read more here.
Our Group Manager, Bob Wilson president & CEO of WorkersCompensation.com, LLC, posted this article, “California Supreme Court Reverses Retro-Active COLA’s in Baker V WCAB” this week as his manager’s choice. Go to read and comment.
Wilson also posted this link to a story about cyber liability in Florida.
Alberto Salgado, MPN coordinator/lead client services liaison at GENEX Services, Inc., in Orange County, Calif., asks, “Medicare Conditional Payments and WC – Can reimbursements to CMS be re-calculated at states’ WC fee schedules (FS)?” He includes this background: “Under the MSP laws (42 U.S.C. § 1395y(b)), Medicare does not pay for items or services to the extent that payment has been, or may reasonably be expected to be, made through a no-fault or liability insurer or through Workers’ Compensation (WC). Medicare may make a conditional payment when there is evidence that the primary plan does not pay promptly, conditioned upon reimbursement when the primary plan does pay. … If the claimant is a Medicare beneficiary, I understand that WC payers are responsible for reimbursement of conditional payments only to medical expenses related the accepted industrial injury and diagnosis. But, can the conditional payment be audited per FS or does it have to be paid at the demanded amounts by CMS?
Jeff Knipper, MSCC, CMSP, medicare services director at CCS Holdings is one of several respondents. He writes, “(In the) Dallas/Fort Worth Area, with few exceptions you’re going to find that Medicare’s reimbursement rate was lower than WC fee schedule allowances so if the ‘conditional payment’ made by Medicare was made for treatment ‘reasonable, necessary, and related’ to the WC claim then the payer realized savings in this scenario.”
John Link, vice president/Tribal Consulting at Cottingham & Butler in Dubuque, Iowa posted this article: Workers’ comp costs from musculoskeletal disease reach $850B a year. It generated this response from Jack Kanner, CEO, COO at P.S.R. Corporation [aka] Professional Safeguard Resources, “Cost containment by workforce cultural change. advise reading attached – link to article – sustainable employees in the infrastructure industries. Musculoskeletal disorders are a by-product of work performance demand and therefore ‘the attitude’ to the work. That may sound like a ‘given’ but I daresay we are eminently qualified to quantify in that we (PSR) have worked with 10s of thousands of varying workforces over 25 years: e.g., firefighters, paramedics, nurses, law enforcement, utilities, manufacturing, warehouse, freight distribution: 100 cities, 3 federal agencies, fortune 500 companies from Chevron Refineries, and Pacific Gas & Electric Co., to Coca Cola, the Federal Reserve Bank. and Mohawk industries (largest flooring co in U.S. – Work Comp $ losses are down millions within 18 months of installation of licensing PSR and certifying facilitators).” Kanner attached this link to an article published by PERI Public Entity Risk Institute: https://www.riskinstitute.org/peri/component/option,com_deeppockets/task,catContShow/cat,91/id,1146/Itemid,84/
There is lots more going on at Linkedin’s Workers Compensation Roundtable right now and right here! Better yet, invite your friends so they too can become informed on hot topics in the Workers Compensation industry.
Workers Compensation Roundtable is jointly managed by people dedicated to the concept that workers compensation is a manageable line on your expense ledger, and that informed professionals are empowered achievers. Workers compensation is not simply a cost of doing business, it is a cost that can be controlled. Beginning with an assessment of cost drivers, benchmarking data, and integrating the solutions, employers can reduce workers comp costs 20 to 50 percent. With proper information, professionals managing compensation claims can reduce costs and improve outcomes for all stakeholders in the process. This group is for employers, business owners, risk managers, HR managers, insurance executives, and brokers to discuss the obstacles and strategies to overcome them.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Our Workers Compensation Book: http://www.wcmanual.com