Vol. 6, Issue 23

Find Solutions & Strategies                    June 8, 2015

Who's "Opting Out" of Workers' Comp--Employers or the States Themselves?
In This Issue
A Note From the Editor
Nat'l Workers' Comp Conference
Larson's National Workers' Compensation Advisory Board
who's "opting out" of workers' comp--employers or the states themselves?

Recent federal court decision discusses ERISA's strong preemption provisions

 

By Thomas A. Robinson, J.D., workcompwriter.com  

  

As I have noted on multiple other occasions, one of the distinctive features of the workers' compensation "opt out" scheme is the employer's establishment of an employee benefit plan that not only meets the basic requirements of the opt out legislation, but also provides some additional benefits-e.g., periodic blood pressure screening, health club discounts, and/or flu shots-in order that the plan qualify under ERISA. By adding such benefits to the state law's core workers' compensation provisions, the employer's plan should qualify under ERISA. ERISA qualification is important since...read more. 
medicare advantage secondary payer
Do Medicare Advantage Organizations have the same reimbursement rights under the Medicare Secondary Payer Act as traditional Medicare?

According to Jennifer C. Jordan, Esq., General Counsel at MEDVAL LLC, the language of the MSP Act is murky. While federal courts have initially applied a strict statutory construction of the law, finding that MAOs cannot bring a private cause of action in federal court to seek recovery from a Medicare beneficiary, they have issued opinions since 2010 that have "devolved into an extremely liberal interpretation in favor of MAOs", giving them what Jordan considers much greater reimbursement rights than what Congress intended. Jordan analyzes MAO recovery rights, surveys current case law, and argues that whether Congress did or did not grant MAOs the right to bring a private cause of action under the MSP Act is something that Congress, not the courts, must clarify. Read the William Mitchell Law Review article. 
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). 

  

Iowa: High Court Allows Apportionment for Prior Disability. Where an Iowa employee worked concurrently for employer A and employer B, sustained compensable permanent injuries while working for A...read more. 

Florida: Surviving Spouse's Fails to Establish Employee's Death Was "Virtually Certain". An appellate court affirmed summary judgment favoring a general contractor in a civil action filed against it by the surviving spouse...read more.

 

Oregon: Employer Need Not Pay for Additional Surgery; Procedure Tangentially Related to Original Injury. Substantial evidence supported a decision that medical services requested by a claimant were not compensable...read more.    

 

North Dakota: Employer Need Not Report Day-to-Day Fluctuations in Employment Numbers. An employer did not lose its right to interpose the exclusive remedy defense in a civil action filed against it by an employee...read more.

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national & state news

NIOSH Research Improves Equipment Design to Help Protect Firefighters.

Congressman Wants to Help Gig Economy Survive, Protect On-Demand Worker Rights.

Bipartisan Legislation Unveiled for Medicare Secondary Payer, Workers Comp Settlements.

AIA Supports Bipartisan Legislation to Improve Administration of Workers Comp Set-Asides.

Obama Signs Bill to Remove Social Security Numbers From Medicare Cards.

College of Workers' Comp Lawyers Announces 2014 Law Student Writing Contest Winner.

AK: Governor Signs HB 178 Extension to Revise List of Workers Comp Medical Fees.

CA: WCIRB C&R Posts Agenda for June 10 Meeting.

CA: WCIRB Governing Committee Posts Agenda for June 10 Meeting.

CA: DWC Issues First 15-Day Comment Period for QME Regulations.

CA: CHSWC Posts IMR, MTUS Presentation From June 4 Meeting.

CA: 1st DCA Sets Oral Argument for Sept. 30 in Stevens Constitutionality Case.

CA: Governor Appoints Hassid as Deputy Director, Legislation & Policy at DIR.

CA: State Fund Names Margie Lariviere as General Counsel.

CA: Ins. Commissioner Appoints New Head of Dept. of Ins. Law Enforcement Branch.

CO: Pinnacol to Expand Into Other States, Launch Employee Wellness Business.

FL: Court Says Judge Should Have Disqualified Himself for Bias.

ID: IC Posts NCCI Rates for 2015.

ID: IC Posts 2014 Annual Report.

IN: WCB Posts 2015 Self-Insurance Application and Guidelines.

IA: Complaints That Branstad Administration Unethically Influenced ALJs Now Resolved.

IL: Governor Decries Workers Comp Reforms Approved by House.

IL: Governor Appoints Joseph Wright as Medical Marijuana Director.

KS: DOL Updates Practice and Procedure Guide.

MA: The Republican Launches Series on Opioid Crisis.

NV: Governor Signs SB 231 Physician Dispensing Limit, Intoxication Burden of Proof.

NV: Governor Signs SB 232 Subrogation Rights.

NV: Bill to Adopt AMA Guides Sixth Dies Due to Strong Opposition.

NY: WCB Proposes Rules as Part of Business Process Reengineering Project.

NJ: NJCRIB Posts 2014 Annual Report.

ND: Air Ambulance Company Sues WSI, Health Dept. Over New Laws.

OK: WCC Posts 5/26/2015 Meeting Minutes on Appeals.

OR: NFIB Director Warns HB 2764 Could Raise Rates by Five Percent.

SC: NCCI Explains 1.9% Loss Cost Filing Increase.

TN: Lawmaker Says Opt Out Bill Amended, Set for Passage Next Session.

TN: Supreme Court to Hear Oral Argument in Workers Comp Surcharges Case.

TX: Governor Signs SB 653 Burial Benefit Increase.

TX: Governor Signs SB 339 Medical Marijuana for Seizure, Epilepsy Patients.

TX: DWC Releases Educational Video for Transition to ICD-10 Code Sets.

WI: Lawmakers Throw Out Governor's Proposal to Transfer WC Agency Functions. 

ENEWSLETTER ARCHIVES

ArchivesTake 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.