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Vol. 4, Issue 13

Find Solutions & Strategies                               April 1, 2013

Caduceus BlackWorkers' Comp Fee Schedules
  
The limitations when it comes to controlling costs
In This Issue
-FEE SCHEDULES
-LARSON SPOTLIGHT: Idiopathic Fall, Slip and Fall, Hepatitis, Heart Attack
-BLOGS: Fraud, Public Self-Insureds, Calif. Reforms, Displaced Worker, Hepatitis C
-NATIONAL NEWS
-STATE NEWS
-eNEWSLETTER ARCHIVES
 A Note From the Editor
Robin Kobayashi 2010 
Dear Work Comp Community:

 

To sign up for this free weekly eNewsletter, click here. To read past issues, access the archives.

 

Sincerely,
Robin E. Kobayashi, JD
LexisNexis Legal & Professional Operations
fee schedules

Stahl, JohnSuccesses and Failures of Fee Schedules: How Medical Providers Circumvent Fee Schedule-Related Revenue Losses, by John Stahl, Esq. Any first-semester political science major can tell you that government regulation is a common method for controlling what a business can charge for goods or services. Fee schedules provide this price control regarding workers' compensation medical costs. Like most forms of government intervention into the free market, this approach has limited effectiveness. Understanding fee schedules requires comprehending the distinction between the "price" and the "cost" of workers' compensation medical services. The "price" refers to the reimbursement that a medical service provider can receive for a treatment; the "cost" refers to the amount that a workers' compensation insurer or other entity that is liable for workers' compensation claims actually spends regarding the services that the claimant ultimately receives. Read more.

larson's on idiopathic fall

Tom Robinson thumbnailIdiopathic Fall From Bridge Arose From Employment, by Thomas A. Robinson. A highway construction worker, who suffered from type I diabetes, was insulin dependent, and whose work required him to be present on a bridge some 60 feet above a river, likely became disoriented due to hypoglycemia on the evening he climbed over a safety barrier and jumped from the bridge, causing serious injury, held the Supreme Court of Kentucky recently in an unpublished opinion. Read more about this case and other cases on Hepatitis, Slip and Fall, and Heart Attack.

lexisnexis workers' comp law community

Fraud SignWorkers' Comp Fraud Blotter: Disabled Cop Caught Playing Baseball.  Read it and other news items.     

  

   

 

  

CWCICalifornia Public Sector Work Injury Claim Payments Remain Near 10-Year High, by California Workers' Compensation Institute. Read it.

 

 

 

 

Robert Rassp grayCalifornia: SB 863 and Benson, by Robert G. Rassp, Esq. Read it.

   

  

 

 

 

CassandraThe Passover Post: Delaware IAB Comments on Residence Status and the Displaced Worker, by Cassandra Roberts, Esq. Read it.

 

 

 

  

Martin KlugMissouri: Lab Tech Proves a Work-Related Hep C Infectionby Martin Klug, Esq. Read it.

national news

7th Circuit Rejects Liberty Mutual's Challenge to AIG Class Action Settlement Order.

NAIC Ranks Top 25 Property & Casualty Insurance Companies for 2012.

Casualty Actuaries Examine Impact of Healthcare Reform on P&C Insurance Industry.

Rising Medical Costs, Terrorism Fears Fuel Rise in WC Insurance Costs for Corporations.

Coventry Advises on Maximizing Out of Network Medical Savings.

US Supreme Court Hears Arguments in Generic Drug Brand Drug Patent Lawsuit.

FDA Seeks to Regulate Pharmacy Compounding.

GEN Updates Top 20 Best-Selling Drugs for 2012.

WCRI to Present Research on Prescription Drug Use in State Workers' Comp Systems.

Cumulative Effect of Noise as Main Cause of Hearing Loss.

CMS Posts NGHP Alert re Reporting Requirements for Batch Files, DDE Submissions.

State news

AK: WCB Proposes Changes to Medical Billing Procedures.

AZ: IC Develops Survey re Evidence Based Medicine Treatment Guidelines.

AR: SB 515 Would Limit TTD Benefits When Employee Terminated for Cause.

CA: DWC Posts Updated Fact Sheets for Injured Workers.

CA: DWC Updates Ambulance Fee Schedule.

CA: DWC Updates Lien Filing Fee Payment System for JET File.

CA: CWCI Elects Board of Directors for 2013.

CA: US Dist Ct Consolidates Three NFL Player Lawsuits re Calif. Workers' Comp.

CA: WCIRB Actuarial Committee to Meet April 1.

CA: Paduda Warns of Opioid Use in Workers Comp at CWCI Annual Meeting.

CA: Zenith Files Lawsuit, Alleges Lapse in Workers Comp Coverage by Marysville Business.

CO: DWC Proposes 1.14 Percent Premium Surcharge, Hearing Scheduled May 9.

CT: Dept of Labor Issues Stop Work Orders to 27 Companies, Investigates Misclassification.

FL: Insurance Groups Request Rehearing in Controversial Westphal TTD Cap Case.

HI: SB 510 re PEO Registration Approved by House Committee.

KY: DWC Increases Mileage Rate From 45 Cents to 47 Cents Per Mile.

MI: WCRI Reports Low Medical Care Costs for Injured Workers.

NV: NCCI Reports Eight Workers Comp Related Bills, Increase in Premium Volume.

NH: Dept of Labor Orders LGC to Increase Bank Guaranty by Nearly $2M.

NH: DHHS Releases Immigrant Worker Survey Report February 2013.

NM: SB 233 Workers Comp Attorney Fee Cap Increase Sent to Governor.

NM: SB 275 Workers Comp Clean Up Bill Sent to Governor.

NC: IC Updates Hospital and Ambulatory Surgery Fee Schedules.

ND: Insurance Commissioner Suspends Ullico's Certificate of Authority.

ND: WSI's Use of Independent Medical Examiners Questioned.

ND: HB 1163 Would Define Pain as Symptom, Not Worsening of Injury.

OH: Inspector General Reports Ohio BWC Employee Wrongfully Accessed Records.

OH: BWC Lists 11 Approved Rule Changes Effective 4-1-2013.

OK: House Committee Files Amendments to Workers Comp Reform Bill.

PA: High Court Clarifies Workers Comp Rule on Retirement.

PA: Ins. Dept. Says Workers Comp Rates to Decline for Some Employers in April.

RI: Workers Comp Court Upholds $1M Penalty for Lack of WC Insurance Coverage.

TN: Attorney Rejects Governor's WC Reform Proposals for Lack of Conservative Ideals.

TN: Labor Commissioner Karla Davis, Two Others Resign.

TX: SeaBright Executive Rejoins Texas Mutual as SVP of Strategic Planning.

TX: DWC Reports Decrease in Non-Fatal, Work-Related Injuries for 2011.

TX: DWC to Hold Hearing re Certification of MMI, Evaluation of Permanent Impairment.

TX: DWC Posts Reminder re Federal Preemption of Medical Fee Dispute Resolution.

WV: Court Sides With Injured Worker on Timeliness of Carpal Tunnel Claim.

WV: Field Auditor, 4 Co-Defendants Plead Guilty to Bilk BrickStreet Mutual.

ENEWSLETTER ARCHIVES

ArchivesTake a deep dive into our past eNewsletters for 2013 and prior...warning - some links to articles may not work...report any linking problems to Robin.E.Kobayashi@lexisnexis.com.

Mar. 25, 2013: Distracted Drivers and Workers' Comp.

Mar. 18, 2013: Impact of Obamacare on Workers' Compensation.

Mar. 11, 2013: Combatting Opioid Addiction: When the Cure Is Worse Than the Disease.

Mar. 4, 2013: Medicare Secondary Payer: The Shape of Things to Come.

Feb. 25, 2013: Why Workers Settle Their Claims.

Feb. 19, 2013: Larson's and the Ambiguous Statute.

Feb. 11, 2013: Supreme Court Rejects "Anything That Floats" Test.

Feb. 4, 2013: Workplace Wellness Programs Return on Investment, Implementation Tips.

Jan. 28, 2013: Depression: The Hidden Cost of Compensable Work Injuries.

Jan. 22, 2013: Workplace Homicide.

Jan. 14, 2013: Opting Out Is the New "In" Thing.

Jan. 7, 2013: The Top 10 Bizarre Workers' Comp Cases for 2012.

ACCESS 2010-2012 ARCHIVES AND ARTICLES LIST HERE.

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