Calif Edition Banner March 2010
Vol 1, Issue 31

Find Solutions & Strategies                                  July 12, 2010

Medical Fraud and Lien Abuse
Practical tips for fraud prevention from an industry insider
In This Issue
* FEATURED ARTICLE: medical fraud & lien abuse
* PANEL DECISIONS: panel QMEs, liens
* PANEL DECISIONS REPORTER: $159/yr. special offer
* NEWS HEADLINES: fee schedule, underwriting loss, experience rating
* BLOG ROUND UP: fraud, CCCs, interest on attorney's fees
* JOB POSTINGS: New feature!
* ARCHIVES: view past eNewsletters

A Note From the Editor

Robin Kobayashi
Dear WC Professionals:
The 20th anniversary of the Americans with Disabilities Act is July 26th. I'll be featuring some new articles on the ADA written by special guest contributors this month.
Robin E. Kobayashi, J.D.
LexisNexis Editorial & Content Development
Americans with Disabilities Act
20th Anniversary July 26, 2010 
Quick Links
WCJ Roster (updated 6/2/10)
EAMS Blogs Index (updated 6/24/2010)
Impairment Guides Resource Center (formerly AMA Guides Resource Center)

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Don't Be Intimidated by Medicare!

 Effective Strategies for Meeting MSA Obligations
 July 17, 2010, Camarillo, CA
 Jennifer Jordan 2 
Instructor: Jennifer C. Jordan, General Counsel, MEDVAL, LLC, Editor-in-Chief of The Complete Guide to Medicare Secondary Payer Compliance (LexisNexis) (Fall 2010)
Find out what is required by law, what is required by CMS, how to identify cases not to submit to CMS for review, how to clean up your case for a better CMS outcome, how to evaluate your vendor's MSA evaluations & much more


How to Stop Some of the Medical Fraud and Lien Abuse in the California Workers' Compensation System. Recent studies from the California Commission on Health and Safety and Workers Compensation indicate that the lien medical problem in Southern California is currently one of the largest unnecessary cost drivers within the workers compensation system. 2007 alone saw over 725,000 liens filed. What are the five major causes of the medical provider fraud and lien abuses? What steps can be taken to help stop fraud liens and abuses in workers' compensation?  Read it.

William Zachry William M. Zachry, Vice President of Risk Management for Safeway, Inc., is also the Chair of the State of California Fraud Assessment Commission.
recent panel decisions - sneak preview
Each week we report a few recent panel decisions that we're considering for the LexisNexis® services:
NOTE: This free eNewsletter reports only a handful of panel decisions each month. If you want notification of all 40 to 65 noteworthy panel decisions added each month to the Lexis database, please consider purchasing our new panel decisions reporter (see box below).

Panel QMEs. Applicant was within her rights to schedule a panel QME evaluation for a time beyond the 60 days set forth in Rule 33(e), when WCAB interpreted the rule as allowing party with right to schedule QME appointment to waive 60-day requirement if QME cannot schedule appointment within 60 days but can do so in fewer than 90 days, even if party's belief that QME cannot comply with 60 day requirement is mistaken. Read the Singer panel decision.


Statute of Limitations; Lien Claims. Lien claimant surgery center was barred by one-year statute of limitations in LC 5405 from recovering lien for services provided to applicant, when applicant did not initiate proceedings by filing application for adjudication, lien claimant was therefore obligated to initiate such proceedings within one-year period set forth in LC 5405, lien claimant did not file application until more than five years after applicant's date of injury and provision of benefits, and fact that defendant admitted injury and furnished benefits did not relieve lien claimant of obligation to comply with statutory time limit. Read the Medina panel decision.


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NEW! Designed especially for subscribers only, this monthly reporter saves you research time so that you can quickly find recent panel decisions on key topics.

Thumbs Up JULY ISSUE: Guest contributor Kenneth M. Sheppard, Esq. on substantial evidence in the absence of a presumption and the statute of limitations defense.
We do the legwork for you: Our editorial consultants pour through hundreds of cases to find noteworthy decisions that you should know about.
What you get each month: Brief summaries of typically 40 to 65 cases, arranged by topic. Commentary articles written by guest contributors.
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news headlines
P2548 CA WC HotDocs
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Top 25 Blogs 2009
View the Honorees
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Fraud SignWorkers' Comp  Fraud Blotter 7/8/2010 - recent arrests, charges, convictions, investigations. Read it.     
Cal Comp CasesCal. Comp. Cases July Advanced Postings 7/9/2010. Stipulations. Statute of Limitations to File Claims. Medical Treatment. SIBTF. VRMA. Injury AOE/COE. Read it.
Goldman Magdalin KrikesPayment of Interest on Attorney Fees in California, by Goldman, Magdalin & Krikes, LLP. Analysis of Koszdin case. Read it.
california top cases
California Top Cases, powered by Cal. Comp. Cases (updated 7/10/2010)
> Koszdin v. SCIF (attorney's fees; interest)
new feature! job postings 
If you would like to post a job, contact
> Workers' Compensation Defense Attorney - Goldman, Magdalin & Krikes, LLP - San Luis Obispo, CA. Read it.
enewsletter archives
June 1, 2010

May 24, 2010

May 17, 2010

May 10, 2010

May 3, 2010

April 26, 2010

April 19, 2010

April 12, 2010

April 5, 2010

March 29, 2010

March 22, 2010

March 15, 2010

March 8, 2010

March 1, 2010

February 22, 2010

February 16, 2010

February 9, 2010

February 2, 2010

January 26, 2010 

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