October 2011 Issue

    

    CHANGES FOR CALIFORNIA 

Compound Drugs, Medical Bills

Come Under New Regulation 

Gov. Jerry Brown has signed a bill that brings compound drugs under the California Official Medical Fee Schedule. WorkCompCentral Western Bureau Chief reported earlier this month that pharmacists view the addition of compounded pharmaceuticals in the fee schedule as a victory. Carriers also supported the legislation. 

Medical billers and self-insurers are under new sets of regulations intended to streamline the process for doing business in California worker's comp. The new regulations took effect this month and WorkCompCentral's Greg Jones examined in an Oct. 24 article the administration's intent and the ramifications of the rule changes affecting the medical providers and the self-insureds. 

"The billing regulations, which went into effect on Oct. 19, require the use of a standard billing form and standard bill-review messages," Greg writes in his Monday article. "The self-insured regulations, which took effect on Oct. 19, require self-insured groups to provide financial information in March rather than in June so regulators can take action before the July 1 start of the policy year." 

WorkCompCentral on Oct. 13 hosted a web workshop to demonstrated how properly to fill in a CMS 1500 form for billing charges, using the new standardized paper medical billing rules. The takeaway message from the webinar, led by billing professionals Catherine Montgomery and Sarah Moray of Clarity Medical Billing Resources of Goleta, Calif., was that bills with errors will be denied.  

The full article is available for viewing or purchase. 

A COMMON FRUSTRATION 

ADDRESSED IN NOV. 7 WEBINAR

When a workers' comp claim takes on an adversarial tone, it can be difficult for an adjuster or attorney to deal with the claimant. What do you do when the injured worker is uncooperative? You are invited to register for a free webinar on Monday, Nov. 7 at 1 p.m. Pacific time for some advice. 


Based on their book "Gaining Cooperation: 3 simple steps to getting the injured worker to do what you want them to do," authors Carl Van and Debra Hinz will highlight basic principles for gaining cooperation. This webinar is specific to workers' compensation, and the lessons relevant in any state where you may practice.

Carl Van is a frequent speaker at conferences and to insurance company employees. He is a graduate of California State University, Sacramento where he received his bachelor's degree in Insurance. He is author of more than 75 technical and soft skill workshops being taught in the United States, Canada, and in the United Kingdom.

Debra Hinz is the founder and past president of the Association of Insurance Professionals (AIP). She teaches workers' comp continuing-education courses in California and is the Southern California manager for Macro Pro legal-copy service.

Attendance is limited to the first 100 people to register.  Register me. 

(The book Gaining Cooperation: 3 simple steps ..." can be purchased online at Amazon.com or by contacting author Debra Hinz at debra.hinz@yahoo.com. It retails for $19.95. Go to Amazon.)

OPIODS: Treating Pain at What Risk?

There is a growing sense among workers' comp observers that opiods are becoming an epidemic. These painkillers are addictive, deadly and they hinder the patient's recovery from a work injury in most cases.

Those are just some of the alarming conclusions you'll hear from a pair of experts, Dr. Thomas F. Jan of Long Island, N.Y., and Joe Paduda, a pharmacy-industry consultant who tracks Rx drug utilization and costs trends in worker's compensation. In two separate presentations (now available online), they explain opiod and how the daily dosage for patients with pain has tripled. This increase carries a risk of addiction and accidental overdose for injured workers under a doctor's care.  The reality is that for any employer and its comp carrier, the overutilization of strong painkillers is a liability risk.  

Program:  Treating Opiod Dependency and Addiction in Work Comp

A one-hour discussion, with PowerPoint slides. Led by Dr. Thomas Jan, an osteopathic physician in private practice located in Massapequa, N.Y. He is credentialed and sub-specializes in Pain Management, particularly patients suffering from alcoholism and addiction. He is board certified by the American Board of Addiction Medicine and has been in the field of addiction medicine for a decade. 

Program:  Prescription Drug Abuse in Workers' Comp

A one-hour discussion, with PowerPoints. Led by consultant and blogger Joe Paduda, this is an overview of critical issues, such as the utilization of narcotics for treating work injuries; benchmark studies about opiods and workers' comp; how the states compare; the risks posed by long-term use of opiods; addiction problems and liability; and encouraging steps being taken to curb the abuse of prescription pain drugs in the states of Washington and California. California CE credits available. 

GUIDE TO GETTING PAID FOR MED-LEGALS

Still Time for QMEs to Enroll in Saturday's Seminar

A special program for Qualified and/or Agreed Medical Evaluators who do work in California is scheduled for Saturday, Oct. 29 at the WorkCompCentral training center in Camarillo. 

The instructors are WCJ Myrle Petty of Riverside and attorney Jon Brissman of Colton. Seating is limited for this CE event that focuses on the med-legal practitioner's role, reports and practice tips. 

QMEs and AMEs who attend will find answers about their roles, responsibilities and those medical-legal reports at an upcoming live seminar at WorkCompCentral, titled, " Road Map for the California QME." We are offering 6 QME continuing-education credits. This training is open to medical-office staff for the QME/AME, and for attorneys who want to learn to critically review med-legal reports. 

Six QME continuing-ed credit hours are available. The seminar price is $329, and $299 for WorkCompCentral eligible subscribers. Call our offices at 866-975-2667 for the special price. 

See what the course is about online.

Coming to the Bay Area ... a PD and DFEC Program

What did Ogilvie III do to the rebuttal criteria laid by the WCAB? Bay area attorneys, paralegals and claims professionals will want to attend this redux of a Southern California program we put on last month.

"Ogilvie III Update and PD Rating Secrets" is the title of the seminar. The date is Saturday, Nov. 5  from 9 a.m. to 4 p.m. at Mills College in Oakland. Six MCLE or Legal Specialization credits with the the California Bar are available.  The instructors are WCJ Colleen Casey of San Francisco and Lexis-Nexis author and comp attorney Robert Rassp of Los Angeles. 


Call 866-975-2667 to sign up. Or see our ad at www.workcompschool.com.

Our final worker's comp legal seminar for 2011 is taking place
next month on the Mills College campus.