April 2012 Issue

 

Taking the Fear Out of Workers' Comp Reform

Today is Friday, the 13th and that fact makes alot of people nervous. Fear of Friday the 13th has a name, too. The scientific name is friggatriskaidekaphobia (pronounced frig-u-trisk-eye-deck-uh-pho-bee-uh). 

The most common fears people share are probably no secret to anyone. I looked up the most common fears online and found the top 10 listed at About.com. In order they are:

1. Spiders                                                          
2. Snakes
3. Heights
4. Being trapped 
5. Dogs
6. Thunder and lightning
7. Injections
8. Social situations
9. Flying
10. Germs 

One noticeable exception missing from the 10 list was fear of change. 

There's been talk recently in California about another event that makes people nervous: workers' comp reform. It's not a matter of "if" reform is coming to California. Business and labor are in agreement that reform can be accomplished, giving injured workers higher benefits and employers some cost savings.

WorkCompCentral Western Bureau Editor Greg Jones is covering the pre-reform activity in Sacramento and around the state, where the Division of Workers' Compensation is on a fact-finding tour to hear from stakeholders what parts of comp need legislative fixing. Nine meetings are scheduled around California, and the first one was held this week in West Sacramento. So, yes, reform is just around the corner. 

Whatever the DWC, labor and business, and the politicians decide to fix, you'll hear about it as it happens by reading WorkCompCentral's Daily Newsletter and email announcements, like this one. 

Dale Carnegie, the author of "How to Win Friends and Influence People," offers this advice for facing whatever fear bothers you: "If you want to conquer fear, do not sit home and think about. Go out and get busy." Need a place to start? How about attending a DWC public forum to listen to the administration and public comments, upon which the DWC might base the reform legislation. 

P.S. April marks the 8th anniversary of SB 899, the last major renovation done on California comp law.

- Rob McCarthy  

MAY 1: HELPING DOCTORS FRUSTRATED BY UR

Medical treaters of all types are encouraged to participate in a free webinar on May 1 at 1 p.m. Pacific time. The title is "The Key To Winning the UR Battle ... Understanding URO Requirements."

This is designed for help providers serving the workers' compensation industry and dealing with utilization reviews. This overview of the requirements of the URO (utilization review organization) clarifies what drives the system. Providers will learn how to submit a request for treatment that results in authorization. The options available when a denial of your treatment request is received will be addressed as well as the challenges encountered throughout the UR process.                                                
                                                                                                                                                                                                                                                                             
Led by Maureen Bennington, a 20-year veteran of workers' compensation. She has a Master's of Science degree in Rehabilitation Administration and is credentialed in Utilization Review, Case Management, Disability Management and Vocational Counseling. Maureen has extensive knowledge related to all managed care products. She has been responsible for the development of case management, medical bill review and utilization review programs, file review and audit procedures, return-to-work programs and disability management product development and implementation          procedures.                    

Read more about the webinar here.

Register now: Yes!

LIVE SEMINAR SCHEDULE FOR APRIL, MAY AND JUNE

There is alot of live training available about rating, lien litigation and writing a psyche report that meets the legal standard for substantial evidence.

APRIL 

April 28, Studio City - "Straight Talk About Using the Guides: An Open Forum Featuring Dr. Gunnar Anderssen, Senior Orthopedics Editor of the AMA 5th." An expert panel will assemble with Dr. Anderssen to discuss Guides issues and controversies.

Six MCLE, Legal Specialization, Rating and Calif. Claims Professional credits available. (QME credit pending)

$299 for WorkCompCentral qualifying subscribers. $329 regular price.

Register: https://ww3.workcompcentral.com/Course/coursedetails/?category=42&id=719


MAY


May, 19, Mills College in Oakland - "Rating PD - The Tricks of the Trade." Led by Colleen Casey and Robert Rassp. Judge Lilla Rados is the keynote speaker. Digs deeper into the most common rating issues and traps in workers' compensation cases. Includes a session about how to depose doctors for the "why's and "how's."

Six MCLE, Rating and Calif. Claims Professional credits available. (QME credit pending)

$299 for WorkCompCentral qualifying members. $329 regular price.

Register: https://ww3.workcompcentral.com/Course/coursedetails/?                  category=42&id=721                                                                                      Judge Lilla Rados 


JUNE

June 2, Orange County Expo Center - "Your Liens - When to Hold 'Em, Fold 'Em and How to Settle." With Jon Brissman, Judge Paige Levy and attorney Sean Hermanson. Focus is on evaluating liens, preparing to litigate liens and going to trial or settlement conference.

Six MCLE, Legal Specialization and California Claims Professional hours.
$299 for WorkCompCentral qualifying members. $329 regular price.

Register: https://ww3.workcompcentral.com/Course/coursedetails/?category=42&id=718

$299 for WorkCompCentral qualifying members. $329 regular price.


June 23, WorkCompCentral Learning Facility, Camarillo - "How to Write a Rateable Psyche Report," led by Dr. Julie Armstrong. Julie will talk about the medical-legal system for workers' comp, the psyche component of a claim, and what a rateable report must contain.

Six MCLE, Legal Specialization hours. QME credit for this seminar is pending.

Registration is being taken by phone, 805-484-0333.

RX BILLING FORM DOESN'T ACTUALLY EXIST - OOPS!

The DWC today sent out a Newsline in which it alerted medical billers for pharmacy and carriers to a billing regulation error. Here's what the DWC said:

"DWC has received inquiries regarding the paper billing form adopted for pharmacy billing. The billing regulation adopts the National Council on Prescription Drug Programs (NCPDP) Workers’ Compensation/Property & Casualty Universal Claim Form and specifies version 1.0 – 05/2008. However, the NCPDP has informed the division that version 1.0 was a draft that was never put into production. The NCPDP form that is available is version 1.1 – 05/2009. DWC intends to revise the regulations to specify the correct version number for the form. In the meantime, it would appear to be reasonable for pharmacies to use version 1.1 and for claims administrators to process bills submitted on that form."

ARIZ. PASSING TREATMENT GUIDELINES  

A bill to implement workers' compensation treatment guidelines is moving in the Arizona statehouse. HB 2368 is an omnibus bill that directs the Industrial Commission to implement treatment guidelines. It also modifies how monthly benefits are calculated, and expand insurer subrogation rights. The Senate has approved the measure, which is now awaiting debate and action in the lower House.

TWO STATES ADOPT OPIODS MEASURES 

IAIABC announced this week that Oklahoma and Massachusetts have adopted new treatment guidelines to deal with opiods abuse. A national RX Drug Abuse Summit also took place this week, ratcheting up the pressure on states to clamp down on prescription practices of narcotics by treating physicians. Joe Paduda, who covers the workers' comp industry on his blog www.managedcarematters.com, attended and filed dispatches from the event. I recommend you check out Joe's blogs. Managed Care Matters

SOMETHING FOR MEDICAL BILLERS AND CODERS

The U.S. Department of Health and Human Services has issued a proposal that will postpone the compliance date for ICD-10, currently scheduled for October 1, 2013, for one full year.

BROWSE TOPICS, ANYTHING THAT'S NEW

We're proud of our continuing-education catalog, and we work hard to line up speakers and topics that are a cut above the rest. So, do us a favor. Bookmark our CE home page and check it regularly for "What's New"and "Weekly Deals" It's a good way to keep informed about us and this industry.

        Staying Informed Doesn't Happen by Accident