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Saturday, August 31, 2013

Cost Shifting vs. Cost Fixing

Cost shifting is a major credibility issue in workers' compensation schemes. Insurance carriers, employers and even employees have been implicated in such conduct. Unless it is resolved it will ultimately jeopardize the entire program. Today's post was shared by WorkCompCentral and comes from

There have always been allegations of cost shifting either to or from workers' compensation and general health. Now Massachusetts is going to study just whether or not this is true, and if so, by how much.

The Massachusetts Department of Public Health is expected to release a report to the state Workers' Compensation Advisory Council in October or November on practices that regulators warned last May may be shifting costs from workers' compensation carriers primarily to MassHealth and to some private health care providers.The alleged problem seems to be three-fold:

  • Employers pressure workers not to report injuries as job-related.
  • Employees use private insurance because of fears they will lose their jobs or suffer some form of retaliation for filing a workers' compensation claim.
  • Some doctors check for secondary insurance and send out bills to all carriers to ensure they get paid.

  • At a meeting of the Advisory Council last May, Massachusetts Department of Industrial Accidents Deputy Director George Noel said the regulatory agency had indications that some workplace injuries are being processed through MassHealth and that community health centers reluctant to accept workers' compensation claims are shifting cases to "other places."Mickey Long, a member of the advisory council and an attorney for the Massachusetts AFL-CIO, said "There are an increasing number of anecdotes going back a decade involving contractors, where a worker is told by the owner of a company to handle...
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