Vol. 6, Issue 8

Find Solutions & Strategies February 23, 2015

Workers' Comp Medical Fraud

Steps to prevent and dissuade fraudulent conduct

In This Issue

* MEDICAL FRAUD

* IBR, LIEN LITIGATION

* CONFERENCE DISCOUNT

* WALTER R. BROPHY, JR.

* WCAB STAFF ATTORNEY

* UNREASONABLE DELAY, DUBON MOOT, SECONDARY PAYERS, ENGINEERING CONTROLS TO REDUCE CLAIMS

* NEWS: Dubon files petition for review in Cal. Supreme Court

* eNEWSLETTER ARCHIVES

A Note From the Editor

Workers' Comp Index : Order at www.lexisnexis.com/WCI

WCRI 31st Annual Conference

standing up to workers' comp medical fraud in california

Karen C. Yotis, our Feature Resident Columnist, provides insights into workplace issues and the nuts and bolts of the workers' comp world.

At the recent Division of Workers' Compensation 22nd Annual Educational Conference held in Los Angeles, the people wielding the California Department of Insurance Fraud Division's investigative big guns came out in force to broadcast two very clear messages. First, the division is comprised of a state-wide team dedicated to the mission of catching the bad guys. Second (but no less important) is that these folks don't expect to get very far without the industry's active support. When it comes to California's wide-reaching plan to ferret out medico/legal fraud and prosecute its perpetrators...read more.

IBR update and lien litigation status

By David Bryan Leonard, Esq.

David Bryan Leonard At the 22nd Annual DWC Educational Conference a terrific panel presented an update on the independent bill review (IBR) process and discussed the status of the constitutional legal challenge to the lien activation fee. Of interest, while there appears to be some clarity of application and factors of ineligibility, there is low utilization of the IBR process...read more.

ATTN: DWC CONFERENCE ATTENDEES SAVE 20%

All DWC conference attendees can take advantage of special conference discounts through March 16, 2015. Whether you want print or ebook, we've got your research solutions:

*Herlick, Calif. Workers' Comp. Handbook (2015 Ed.)

*Workers' Comp. Laws of Calif. (2015 Ed.)

*Workers' Compensation Index (2015 Ed.)

*Rassp & Herlick, California Workers' Compensation Law

*Hanna, Calif. Law of Employee Injuries & Workers' Comp.

*Lawyer's Guide to AMA Guides & Calif. WC (2015 Ed.)

To take advantage of this offer, contact Christine Hyatt:

Direct: 937-247-8166

Email: Christine.E.Hyatt@lexisnexis.com

Receive a complimentary booklet on reducing workers' comp costs when you contact Christine to purchase a LexisNexis book! Offer good while supplies last.

in memoriam: walter riley brophy, jr.

This tribute will appear in the February 2015 issue of California Compensation Cases

Walter Riley Brophy, Jr. (Walt) passed away on February 7, 2015, at the age of 90 after a long and distinguished career in the field of workers' compensation as a lawyer, judge, administrator and mediator. A native Californian, Walt served his country proudly in the United States Navy during World War II for four years in the Pacific Theater. After his naval service, Walt went on to study law and was admitted to the State Bar of California...read more.

job opening: wcab staff attorney

Deadline for applications is February 27, 2015

The Workers' Compensation Appeals Board, Office of the Commissioners in San Francisco, seeks a candidate to fill one full time permanent staff attorney vacancy at one of the following levels depending on experience:

Industrial Relations Counsel II $6,473 - $8,304 salary plus benefits

Industrial Relations Counsel III $7,836 - $10,054 salary plus benefits

The duties for each position are as follows...read more.

lexisnexis legal newsroom blogs

Cal Comp Cases Defendant's 39-Day Delay of $49K Settlement Found Unreasonable: Cal. Comp. Cases February Advanced Postings. Lexis.com and Lexis Advance subscribers can read it.

Dubon's Petition for Writ of Review Denied as Moot: Cal. Comp. Cases February Advanced Posting. Lexis.com and Lexis Advance subscribers can read it.

Workers' Compensation and Its Secondary Payers: Medicare and Medicaid, by Vernon Sumwalt, Esq. Read it.

Insurer-Supported Engineering Controls Can Lead to Significant Reduction of Overall Workers' Comp Claims and Costs, by Thomas A. Robinson, Esq. Read it.

california news headlines

CA: Dubon Files Petition for Review With Calif. Supreme Court.

CA: DWC Posts Changes to OMFS (Physician/Non-Physician Practitioner Services).

CA: SCIF Offers Free Physician Training to Prevent Overprescribing of Opioids.

CA: Doctor Blasts Law Enforcement Raid of His Pain Care Institute.

CA: Injured Worker With $50K Workers Comp Judgment Murdered in Planned Robbery.

CA: Former Senator Calderon Works in Real Estate While Awaiting Trial.

House Bills Filed Seek End of Federal Prohibition on Marijuana.

FDA Issues Draft Documents for Compliance With Laws on Compound Drugs.

GENEX White Paper Examines Tipping Points of Routine Workers Comp Claims.

WCRI Names New Executive Director and New CEO.

NPR Series Examines Plight of Injured Nurses.

Naturopathic Doctor Examines "Dark Side" of Workers Comp, Healthcare Systems.

Study: Patients Using Longer-Acting Opioids Have Higher Risk of Accidental Overdose.

Abuse Deterrent Formulation Technology Morphine May Help Prevent Opioid Abuse.

Study: Scientists Discover Why Marijuana Increases Appetite.

High Tension Shooter Drills Lead to Comp Claims Filed by Teachers.

eNewsletter archives

Take a deep dive into our past eNewsletters for 2015 and prior...warning - some links to articles may not work...report any linking problems to Robin.E.Kobayashi@lexisnexis.com.

February 17, 2015: Special Issue on QMEs and AMEs.

February 9, 2015: A Post-Dubon II Game Changer?

February 2, 2015: Stipulation to Treatment Outside Medical Provider Network.

January 26, 2015: UR Cycles of Denials and Authorizations of Prescription Medicines.

January 20, 2015: Rolda Reloaded.

January 12, 2015: Opioids - The Grand Debate.

January 5, 2015: Top 25 Noteworthy Panel Decisions: July - Dec. 2014.

CLICK HERE TO ACCESS 2010-2014 ARCHIVES.

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