Vol. 6, Issue 21

Find Solutions & Strategies May 26, 2015

U.S. Health Industry Often Guilty of "Overkill"

Significant percentage of medical care procedures is unecessary

In This Issue

- HEALTH CARE "OVERKILL"

- LARSON'S: Average Weekly Wage, Sole Proprietor, Natural Consequence, Theft by Deception

- NATIONAL & STATE NEWS

- eNEWSLETTER ARCHIVES

A Note From the Editor

Nat'l Workers' Comp Conference

Larson's National Workers' Compensation Advisory Board

medical expert says u.s. health industry often guilty of "overkill"

Significant percentage of medical care procedures is unnecessary

Thomas A. Robinson, J.D., our Feature National Columnist, is the co-author of Larson's Workers' Compensation Law (LexisNexis).

Much has been written about the explosion of health care costs in the workers' compensation system. Indeed, most experts agree that medical care expenses now represent more than 60 cents out of every benefit dollar provided to injured workers. To the extent that the delivery of medical care within the workers' compensation setting mirrors the care provided generally to patients in the United States, an alarming amount of it is wholly unnecessary. At least, that is the implication of a recent article by Atul Gawande, MD, published in The New Yorker...read more.

LARSON'S SPOTLIGHT ON RECENT CASES

Thomas A. Robinson, J.D., our Feature National Columnist, is the co-author of Larson's Workers' Compensation Law (LexisNexis).

South Dakota: Wages From Multiple Employers Should Be Aggregated to Compute Injured Employee's Average Weekly Wage. Adopting the "growing minority view" identified in Larson's Workers' Compensation Law, the Supreme Court of South Dakota held that the wages an injured employee earned at three, unrelated employments should be aggregated for...read more.

Kentucky: Sole Proprietor Enjoys No Coverage for Injury Under Workers' Comp Insurance Policy. A sole proprietor was not entitled to workers' compensation benefits following a work-related injury where an exclusion endorsement specifically named him as excluded from coverage for...read more.

Mississippi: Employee's Kidney Disease Was Natural Consequence of Medication Taken for Earlier Admitted Injury to Lungs. A Mississippi appellate court affirmed an order of the state's Workers' Compensation Commission requiring an employer to pay for medical treatment related to a kidney condition caused by...read more.

Maine: "Injured" Worker's Clandestine Business Operation Results in "Theft by Deception" Conviction. The Supreme Judicial Court of Maine affirmed the conviction entered in the trial court on a jury verdict finding a person receiving workers' compensation disability benefits guilty of theft by deception...read more.

national & state news

NCCI Symposium Reports First Responder Bills Top List of 2015 Legislation.

NCCI Symposium: Dr. Victor Shares Insights on Physician Dispensing.

NCCI Symposium: CWCI Shares Insights on Calif. Medical Dispute Resolution.

NCCI Symposium: Moody's Presents U.S. Macro Outlook.

NCCI Symposium: Dr. Hartwig Presents On-Demand Economy Implications for Comp.

NCCI Symposium: Expert Discusses Impact of New Technologies on Society.

NCCI Symposium Examines Impact of Workers Comp Rx Fee Schedules.

Workers Comp Indemnity Payments Could Be Costing Payers More Than Necessary.

House Subcommittee Hears Testimony for US DOL Proposal to Cut FECA Benefits.

Democrats Respond to US DOL's Proposal to Cut FECA Benefits.

NIOSH Free Online Course: Strategies for Nurses Working Shift Work, Long Work Hours.

ABC News 20/20 Spotlights How Workers Comp Fraud Investigators Catch Fraudsters.

Silicon Valley Exec Says Robots to Take Over Many Service Sector Jobs by 2033.

ALEC Releases 2015 Rich States Poor State Economic Outlook Survey.

AL: DEA's "Operation Pilluted" Cracks Down on Pill Mills in Alabama.

AR: DEA's "Operation Pilluted" Cracks Down on Pill Mills in Arkansas.

CA: Governor Reappoints Deidra Lowe, Appoints Jose Razo as WCAB Commissioners.

CA: DWC to Hold Hearing to Revise Hospital Outpatient Depts./ASCs Fee Schedule.

CA: DWC Drafts Rules for Transition of DWC Regs, Forms to ICD-10.

CA: Drobot, SCIF Complaints Reveal Depth of Medical Fraud Alleged in RICO Action.

CA: WCIRB C&R to Review Proposed Changes to Recording, Reporting of Data Rules.

CT: Senate Passes SB 593 First Responder PTSD Expansion of WC Coverage.

ID: Idaho Insurance Fund Begins $35M Pay Out for Settlement in Dividend Lawsuit.

IL: House Dems Vote Down 3 Amendments in Governor's Workers Comp Proposal.

IL: House Dems Adopt Amendment for Establishing Process for Workers Comp Rates.

IL: Bill to Extend Medical Marijuana Program by Two Years Sent to Governor.

IL: Bill to Decriminalize Possession of Small Amounts of Marijuana Sent to Governor.

KS: Court Extends Firefighters Rule to Bar Tort Recovery by Law Enforcement Officer.

KS: Dept of Labor Posts Latest Maximum/Minimum Benefit Changes.

LA: WCRI: Little Change in Costs Per WC Claim Following Several Years of Growth.

LA: DEA's "Operation Pilluted" Cracks Down on Pill Mills in Louisiana.

LA: Senate Committee OKs Bill on Possession of Small Amounts of Marijuana.

ME: Workers Comp, MEMIC Help Injured Worker Go Bionic With i-Limb App.

MD: Health Dept. Reports 21 Percent Jump in Fatal Drug Overdoses.

MA: Health Care Services Board to Discuss Latest Draft of Opioid Protocol.

MA: Mass. Medical Society Issues Opioid Prescribing Guidelines for Physicians.

MN: Governor Signs HF 2193 DRG Fee Schedule, eBilling.

MN: Omnibus Jobs Bill With WC Cost Savings Reform Becomes Political Football.

MN: Governor Vetoes Bill to Fund the Workers' Compensation Court of Appeals.

MS: DEA's "Operation Pilluted" Cracks Down on Pill Mills in Mississippi.

NE: Senate Passes Bill to Conduct Study on Cannabis for Seizure Sufferers.

NM: Governor Appoints New Deputy Director for WCA.

NY: Governor Introduces Legislation and Plan to Protect, Educate Nail Salon Workers.

NY: New York Ranked Worst State in 2015 Rich States Poor States Economic Outlook.

OH: BWC Says Drug Formulary Driving Decline in Opioid Prescriptions.

OH: BWC Reminds Employers to Take Action to Receive $1.2B Workers Comp Credit.

OH: Attorney General Rejects Third Petition to Legalize Marijuana.

OR: Governor Signs SB 371 Beneficiaries' Request to Reconsider Claim Closure.

OR: WCD Updates Benefit Rates Based on Annual Average Weekly Wage for 2014.

OR: WCD Updates TD/PPD Calculators With New SAWW.

OR: WCD Updates Maximum Attorney Fees.

SC: Lawmakers File HB 4197 Opt Out Modeled After Oklahoma Opt Out System.

TN: High Court to Hear Oral Arguments: Job Applicant Comp Claim Failure to Hire.

TX: Judge Might Sanction Hospital for Withholding Documents in Ebola Nurse Lawsuit.

TX: DWC Proposes Changes to DWC Form-048 Request for Travel Reimbursement.

TX: WCRI Study Finds Slow Growth in Texas Workers Comp Claims.

TX: Medical Marijuana Seizure Sufferers Bill Sent to Governor.

TX: DWC Announces Recent Enforcement Actions.

UT: Utah Ranked #1 in 2015 Rich States Poor States Economic Outlook.

VA: WCC Warns of Critical WebFile Update Requiring Username Starting 6/26/2015.

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.

May 18, 2015: The Evolving Risk of Firefighter Cancer.

May 11, 2015: What's Really Behind the Decline in Workers' Comp Claim Rates?

May 4, 2015: The Path of Non-resistance in Workplace Robberies.

Apr. 27, 2015: ACOEM Guidance on Marijuana in the Workplace.

Apr. 20, 2015 Seasonal Patterns in Occupational Risk.

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