The legislation will be the subject of consideration by the NJ Assembly Labor Committee on Monday, May 14, 2012.
Click here to read: Clearing the Workers' Compensation Benefit Highway of Medical Expense Land Mines
By John H. Geaney and Jon L. Gelman
"Medical expenses in contested workers’ compensation cases are now a significant and troublesome issue resulting in uncertainty, delay and potential future liability. Th recent NJ Supreme Court decision, University of Mass. Memorial Hospital v. Christodoulou, 180 N.J. 334 (2004) has left the question of how to adjudicate medical benefits that were conditionally paid or paid in error. Presently there is no exclusively defined procedure to determine the allocation, apportionment of primary responsibility for unauthorized medical expenses and reimbursement."
Statement of the Bill
"This bill prohibits the charging of workers’ compensation
claimants for medical expenses that have been authorized by the
employer or its carrier or its third party administrator, that have
been paid by the employer, its carrier or third party administrator
pursuant to pursuant to the workers’ compensation law, or which
been determined by the Division of Workers’ Compensation to
be the responsibility of the employer, its carrier or third party
administrator. The bill gives the division sole jurisdiction over
disputed work-related medical claims, and directs the division to
provide procedures to resolve those disputes, including procedural
requirements for medical providers or any other party to the
dispute. Finally, the bill provides that the treatment of an injured
worker or dependent of an injured or deceased worker shall not be
delayed because of a claim by a medical provider. "
Further Reference:
NJ Task Force Report on Medical Provider Claims
Related articles
"Medical expenses in contested workers’ compensation cases are now a significant and troublesome issue resulting in uncertainty, delay and potential future liability. Th recent NJ Supreme Court decision, University of Mass. Memorial Hospital v. Christodoulou, 180 N.J. 334 (2004) has left the question of how to adjudicate medical benefits that were conditionally paid or paid in error. Presently there is no exclusively defined procedure to determine the allocation, apportionment of primary responsibility for unauthorized medical expenses and reimbursement."
Statement of the Bill
"This bill prohibits the charging of workers’ compensation
claimants for medical expenses that have been authorized by the
employer or its carrier or its third party administrator, that have
been paid by the employer, its carrier or third party administrator
pursuant to pursuant to the workers’ compensation law, or which
been determined by the Division of Workers’ Compensation to
be the responsibility of the employer, its carrier or third party
administrator. The bill gives the division sole jurisdiction over
disputed work-related medical claims, and directs the division to
provide procedures to resolve those disputes, including procedural
requirements for medical providers or any other party to the
dispute. Finally, the bill provides that the treatment of an injured
worker or the payment of workers’ compensation to an injured
worker or dependent of an injured or deceased worker shall not be
delayed because of a claim by a medical provider. "
Further Reference:
NJ Task Force Report on Medical Provider Claims
Related articles
