Workers Compensation Around the U.S. This Week

Work Comp Roundup Wants to Meet You at RIMS Booth 1425

The Philadelphia RIMS 2012 Annual Conference & Exhibition will provide a unique opportunity to gather information and resources to help minimize workers comp costs. This year there are sessions for many experience levels and the exhibit hall will have US! Yes! Held at the Pennsylvania Convention Center located on 1101 Arch Street will be Amaxx and WorkCompRoundup at booth 1425.

“If anyone wants to stop by to say hello or chat about workers compensation issues, I welcome them to do that,” says Becki Shafer, CEO. “For companies struggling with high WC costs, the exhibit hall is a great place to see all the different solutions that are available in the marketplace and attend seminars. One of the best things I did when I began my career in workers compensation was attend RIMS in Atlanta, it was the first conference on Workers Comp I attended, and I was pleasantly shocked at everything that was available — it was like walking through a supermarket of ideas.”

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Learn more about the convention here.

Keystone Case Management Could Give you a PINCH this Spring

Keystone Case Management is a young company in the Workers’ Compensation World, says owner and president, Kelly Haile, RN, CCM, WCCM. This team of nurses has developed PINCH, a solution that uses employer education and aggressive case management to help employers and injured workers

PINCH has resulted in a decrease in claim report numbers, out-of-work time and fewer litigated claims, Haile says. “The program has also shown increased satisfaction by injured employees, and employers are delighted at the clear, consistent and timely information that is provided,” she writes.

The company recently announced it is a finalist in Dorland Health’s Case In Point Platinum Awards for Workers’ Compensation Case Management and will be hosting a half-day educational workshop for employers April 4th, 2012 in Drexel Hill, PA. For more information contact info@KeystoneCaseManagement.com or (610) 469-NURSE.

LexisNexis Communities Offers This Week Work Comp In Review

The Workers Compensation Law Community Powered by Larsons on LexisNexis offers several great pieces this week:

Larson’s Spotlight, found here, focuses on the following recent cases, compiled by Thomas A. Robinson, staff writer for Larson's Workers' Compensation Law:

TN: Truck Driver Deviated From Employment by Leaving Truck to Search for Object With Which to Assault Driving Partner

TN: Court Affirms Denial of Benefits Related to Unexplained Fall to Level Floor

OH: Physician's Opinion Was Not Equivocal Where Physician Modified Opinion in Light of Videotape Evidence of Injured Worker's Capabilities

FL: Judge May Not Sanction Homeless Claimant for Failure to Pay Prevailing Party Costs-Failure to Pay Was Not Willful

Robin E. Kobayashi writes The Sticky Wicket That Is Home Health Care: Why It’s a Hotly Contested Issue in the Workers’ Compensation Arena

The article, found here, asks, “An injured employee’s entitlement to home health care is oftentimes a hotly contested issue in the workers’ compensation arena. Home health care issues can vary in nature. For instance, at what point does the marital obligation cease and the paid nursing services begin?”

The author looks into these types of issues in Nebraska, Iowa, Arkansas, and California.

Lastly, the LN Community recommends these WC fraud blogs this week:

Workers' Comp Fraud Blotter: Mechanic Covered With Grease Claimed He Was Unemployed and Unable to Work,by LexisNexis Workers' Compensation Law Community Staff. Here.

“The Case of the Purple Robe … and a Little Motion Day Magic” in Delaware, by Cassandra Roberts, Esq. Here.

Missouri: Employer Penalized for Lapses in Prescription Payments, by Martin Klug, Esq. Found here.

Broadspire Combats Physician-Dispensed Drugs

In a recent release, Broadspire draws from the Workers Compensation Prescription Drug Study: 2011 Update by Barry Lipton, Chris Laws and Linda Li, National Council on Compensation Insurance, August 2011.

They write, “The price of physician dispensed drugs increased by 300 percent between 2005 and 2009. In contrast, the average price of medications dispensed by pharmacies grew by only 23 percent during that same timeframe.”

The company goes on to say the percentage of workers compensation medical costs going toward physician dispensed prescriptions increased to 28 percent in 2009, up from 23 percent in 2008. “Physician dispensed medications have become prevalent in almost every state,” Broadspire concludes.

To combat this medical cost driver, Broadspire has created the following jurisdictionally specific strategies:

1. Through data mining, Broadspire identifies physicians who are dispensing prescriptions from their offices.

2. Targeted communications are sent to these physicians promoting the clinical safety and efficacy offered by Broadspire’s network of retail pharmacies.

3. Safety checks, through network pharmacies, help physicians ensure medications they prescribe are not duplicated by other physicians and that no adverse drug interactions are present.

4. Case managers visit and communicate with physicians to share the Broadspire message and support the use of network pharmacies.

5. Where jurisdictionally possible, Broadspire re-prices provider-dispensed medications to our network pharmacies contracted rate.

Texas Department of Insurance – DWC Seeks Public Comment on Amendment Proposals on MDR

The Texas Department of Insurance Division of Workers’ Compensation is accepting public comments on proposals to amend 28 TAC §§133.307, 133.308, 144.1–144.7 and 144.9–144.16 Regarding MDR of Fee Disputes, MDR by Independent Review Organizations, and Arbitration.

According to a release, the amendments relate to medical dispute resolution (MDR) activities conducted by the TDI-DWC. “The purpose of these amendments is to conform the rules to various statutory amendments that concern medical fee dispute resolution and the resolution of disputes of independent review organization (IRO) decisions by the TDI-DWC. Specifically, these proposed amendments are necessary to clarify existing rules and implement and enforce statutory provisions of House Bill (HB) 2605 and Senate Bill 809, enacted by the 82nd Legislature, Regular Session, that impact the appeal of medical fee dispute resolution cases and decisions issued by IROs,” it says. [WCx]

The proposals will publish in the March 23, 2012, issue of the Texas Register and may be viewed on the Secretary of State website at http://www.sos.state.tx.us/texreg/index.shtml once published. A courtesy copy of the proposals is currently available on the TDI website at http://www.tdi.texas.gov/wc/rules/proposedrules/index.html.

Note: If your company has any developments you'd like to share, please send them up us at: RShafer@ReduceYourWorkersComp.com

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and 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. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.

WORKERS COMP MANAGEMENT MANUAL: www.WCManual.com

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MODIFIED DUTY CALCULATOR: www.LowerWC.com/transitional-duty-cost-calculator.php

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

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