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BEFORE OFFICES EMPTY FOR THE HANUKKAH AND CHRISTMAS WEEK CELEBRATIONS, I WANT TO SEND BEST WISHES FOR THE HOLIDAYS. THANK YOU FOR READING US EACH MONTH AND FOR FOLLOWING US ON FACEBOOK AND LINKEDIN. PEACE AND JOY .... ROB, SAM AND JAKE. |
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Some Random Stuff Before 2012 Arrives ...
Things to be thinking about now ...
- Electronic Medical Billing Officially Begins in California Next Year. Only the carriers and the payers are required to participate, however, medical providers, DMEs, PBMs and medical service providers may want to look into e-billing, too.
- Medicare Set-Asides on workers' comp awards and settlements continue to be a slippery slope. I'm told the only thing certain about MSAs is that the federal government is NOT backing down.
- Opioids and Schedule II narcotics burst onto the workers' comp radar screen this year. Washington state is the model right now for controlling the prescription of addictive painkillers to treat pain.
- The U.S. economy isn't creating jobs quickly enough. Hiring remains flat in construction and manufacturing. It's picking up jobs mainly in hospitality, retail (in November), professional services and health care. The economy added 210,000 jobs last month and another 100,000 in October, the Labor Dept. said.
- New York state is still sorting out the massive defaults in the self-insured trusts. Employers who joined industry risk pools are being held liable for hundreds of millions of dollars for comp claims.
- The AMA Guides Sixth Edition were adopted this year for use in Illinois, where workers' comp arbitrators can refer to this latest edition of the guides for evaluation of disability.
- Medical cost-containment services, such as utilization and bill review, are behind the runup in claims costs in California, according to studies. The same is happening in Texas.
- Social media is the newest tool for detecting claimant fraud. Investigators and claims adjusters routinely look at Facebook and verify that a claimant isn't lying about being physically unable to return to work due to lingering pain or injury.
Did I miss anything in your state or industry? If so, write me at rob@workcompentral.com and I'll print your submission.
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Congratulations to the QME Class of Fall 2012
Eighty doctors who took the California Qualified Medical Evaluator Competency Exam in October passed. The state administers the exam twice each calendar year in Northern and Southern California locations. Before QMEs can begin a practice, they are required by law to take 12 hours of disability-evaluation report writing instruction. For information about becoming a medical evaluator, visit the DWC website. Take me there.
WorkCompCentral offers this pre-licensing course online. See.
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Upcoming Webinar Aims to Turn Payer Data into Action
Jan. 9 - "Where the Most Valuable Asset for Managing Claims and Risk is Buried." Presented by Karen Wolfe. This is a discussion about workers’ comp data (claims, bill review, pharmacy etc.) and how it’s being used to improve business operations and decision-making by workers’ comp executives. Claims and TPA executives and risk managers will benefit from this discussion. Free to attend.
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Do the costs of your workers' comp program need trimming next year? Attorney Frank Russo of Oakland and former Oakland WCAB Presiding Judge George Mason delivered a one-hour talk this month about mediating workers' comp disputes. You can catch the program on a replay by clicking here.
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