The legacy of the COVID-19 pandemic persists. There exists a continuing need for long-term treatment and disability. While state benefit systems such as workers’ compensation have made an admirable attempt in many jurisdictions to provide benefits, a significant gap and non-uniform delivery of benefits continue to exist among jurisdictions. Federal efforts are expanding to provide necessary research and treatment protocol resources.
Showing posts with label Federalization. Show all posts
Showing posts with label Federalization. Show all posts
Tuesday, August 8, 2023
Friday, July 28, 2023
President Biden Announces New Actions to Protect Workers from Extreme Heat
Millions of American workers are currently experiencing the effects of extreme heat, which is growing in intensity, frequency, and duration due to the climate crisis. President Biden requests the Department of Labor to issue Hazard Alerts for Heat and take other actions to protect workers from extreme heat.
Sunday, May 24, 2020
Kennedy proposes Essential Worker Compensation Fund
As thousands of essential workers battle COVID-19 and hundreds more have died from the virus, Congressman Joe Kennedy III today unveiled the COVID-19 Worker Benefits Program (CWBP) to cover economic losses for workers and provide death benefits for the families of workers who have died. Kennedy’s proposed fund would provide $250,000 and economic loss compensation for any essential worker who died from COVID-19, plus an additional $100,000 for the spouse and each dependent of the victim. For workers who survived the virus, it would distribute benefits based on wage losses and medical costs.
Friday, July 1, 2016
US Worker Infected by Zika Virus - Is the Workers' Compensation System Ready?
The emerging viral infection, Zika, is now begun to plaque US workers. The Pennsylvania Allegheny County Department of Health (ACDH) reports that a researcher was infected by a needle stick wound. This is the 4th confirmed case of Zika virus reported by the ACHD.
Friday, March 4, 2016
The National Association of Workers’ Compensation Judiciary March 2016 Newsletter
I strongly urge you to read The National Association of Workers’ Compensation Judiciary March 2016 Newsletter for cutting edge information concerning national workers' compensation issues.
Thursday, November 12, 2015
Emerging Concepts for Future Workers' Compensation Benefits: Portability Now
Workers' Compensation as a benefit program is beginning to evolve under the concept of "The Shared Economy." Attacked from within and without, challenged by abuse and fraud, drained by the cottage industries and vendors, national lawmakers, labor leaders, insurance companies, governmental agencies, and the media, are speaking out to change the century old system that fails to integrate with current social, political, economic and medical programs.
"We need a portable vehicle for worker protections and benefits.Traditionally, benefits and protections such as workers compensation, unemployment insurance, paid time off, retirement savings, and training/development have been, largely or partly, components of a worker’s employment relationship with an employer. The Affordable Care Act has disrupted that model, providing more independent workers a different avenue of access to health insurance. Another new model is needed to support new ways of work. We believe this model should be:
● Independent: Any worker should be able to access a certain basic set of protections as an individual regardless of where they source income opportunities.
● Flexible and pro-rated: People are pulling together income from a variety of sources, so any vehicle should support contributions that can be pro-rated by units of money earned, jobs done, or time worked, covering new ways of micro-working across different employers or platforms.
● Portable: A person should be able to take benefits and protections with them in and out of various work scenarios.
● Universal: All workers should have access to a basic set of benefits regardless of employment status.
● Supportive of innovation: Businesses should be empowered to explore and pilot safety net options regardless of the worker classification they utilize.
A recent letter from national labor leaders has called for a "portable" system of benefits that will replace the current patch-work of systems called "workers' compensation programs.":
"We need a portable vehicle for worker protections and benefits.Traditionally, benefits and protections such as workers compensation, unemployment insurance, paid time off, retirement savings, and training/development have been, largely or partly, components of a worker’s employment relationship with an employer. The Affordable Care Act has disrupted that model, providing more independent workers a different avenue of access to health insurance. Another new model is needed to support new ways of work. We believe this model should be:
● Independent: Any worker should be able to access a certain basic set of protections as an individual regardless of where they source income opportunities.
● Flexible and pro-rated: People are pulling together income from a variety of sources, so any vehicle should support contributions that can be pro-rated by units of money earned, jobs done, or time worked, covering new ways of micro-working across different employers or platforms.
● Portable: A person should be able to take benefits and protections with them in and out of various work scenarios.
● Universal: All workers should have access to a basic set of benefits regardless of employment status.
● Supportive of innovation: Businesses should be empowered to explore and pilot safety net options regardless of the worker classification they utilize.
Monday, October 5, 2015
And they didn't see it coming........
Rafael Gonzalez authored a very helpful, and spot on, post today that summarizes the new approach of The Centers for Medicare and Medicaid Services (CMS) to recoup benefits under Medicare Secondary Payer law (42 U.S.C. § 1395y(b)) (MSP) before a final determination is made in the underlying workers' compensation claim.
Additionally, the cottage industries (lawyers, insurance carriers & employers, ie. MARC) who lobbied for The Strengthening Medicare and Repaying Taxpayers (SMART) Act of 2011, never saw the forest from the trees as they tried to stake out their territory.
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| Rafael Gonzalez |
With multiple reporting trigger points CMS is new able to capture data quickly and with the implementation of the expedited US Treasury debt collection procedures, the Digital Accountability and Transparency Act (DATA Act). the process will now ignore the sluggish/delayed workers' compensation program/adjudication.
CMS has now operationalized a new procedure, "As part of the continuing efforts to improve the Coordination of Benefits & Recovery (COB&R) program and claims payment accuracy in Medicare Secondary Payer (MSP) situations, the Centers for Medicare & Medicaid Services (CMS) will be transitioning a portion of the Non-Group Health Plan (NGHP) recovery workload from the Benefits Coordination & Recovery Center (BCRC) to its CommercialRepayment Center (CRC)."
Ironically, this process cuts through the red tape and cottage industry's interests of the State programs and moves the claims to the goal of Federalization of the entire system based also on a uniformity of processing, coding and determinations at the Federal administrative level. See also, D. Torrey, The Federalization Standards Issue, A Short History Before and After NFIB v. Sebelius (2012), ABA, 2013. "These views speak loudly to the expectation of educated observers that state-based workers’ compensation will endure and that federalization is unlikely."
CMS has now operationalized a new procedure, "As part of the continuing efforts to improve the Coordination of Benefits & Recovery (COB&R) program and claims payment accuracy in Medicare Secondary Payer (MSP) situations, the Centers for Medicare & Medicaid Services (CMS) will be transitioning a portion of the Non-Group Health Plan (NGHP) recovery workload from the Benefits Coordination & Recovery Center (BCRC) to its CommercialRepayment Center (CRC)."
Ironically, this process cuts through the red tape and cottage industry's interests of the State programs and moves the claims to the goal of Federalization of the entire system based also on a uniformity of processing, coding and determinations at the Federal administrative level. See also, D. Torrey, The Federalization Standards Issue, A Short History Before and After NFIB v. Sebelius (2012), ABA, 2013. "These views speak loudly to the expectation of educated observers that state-based workers’ compensation will endure and that federalization is unlikely."
Perhaps, the very next step may be an effort to follow the liability program models, wherein pre-disposition, alternate resolution, is possible early in the process, ie. the mass tort specialized programs for resolution.
Of course, workers' compensation (WC) insurers and employers would then need to really expedite WC claims. But then, wasn't that the intent of the now antiquated 1911 system anyway?
Click below to read the post on LinkedIn:
New Process for Primary Payers Resolving Medicare Conditional Payments Begins Today
Click below to read the post on LinkedIn:
New Process for Primary Payers Resolving Medicare Conditional Payments Begins Today
Sunday, June 23, 2013
Single Payer A Possibility for New York City Employees
The single payer medical benefit system, a program that brings workers compensation into a universal care program, maybe the future for NY City employees. Anthony D. Weiner, a Democratic Candidate, is proposing the change.
"Vowing to “make New York City the single-payer laboratory in the country” if he is elected
mayor, Anthony D. Weiner on Thursday presented an ambitious plan to create a Medicare-like system for the coverage of municipal workers, retirees and uninsured immigrant residents left out of the Affordable Care Act."
Click here to read: "Weiner Wants City to Test Single-Payer Health Care" The NY Times
"Vowing to “make New York City the single-payer laboratory in the country” if he is elected
Click here to read: "Weiner Wants City to Test Single-Payer Health Care" The NY Times
Friday, May 17, 2013
Obamacare Will Be Collecting Workers' Compensation Medical Records
The implementation of Affordable Care Act data collection regulations will include the collection of medical information concerning work related accidents and injuries. The coalition of this information will broadly advance the concept of universal medical care and impose yet another route for the Centers for Medicare and Medicare to strengthen enforcement under the Medicare Secondary Payer Act.
The largest and most expansive database of personalized medical information is being established under the umbrella of an newly created unit under the authority granted to the Internal Revenue Service, The Federal Data Services Hub. Personal medical records, including electronic medical records, will be incorporated into the program.
"On March 23, 2010, the President signed into law the Patient Protection and Affordable Care Act
(P.L. 111-148). On March 30, 2010, the Health Care and Education Reconciliation Act of 2010
(P.L. 111-152) was signed into law. The two laws are collectively referred to as the Affordable
Care Act. The Affordable Care Act creates new competitive private health insurance markets –
called Exchanges – that will give millions of Americans and small businesses access to
affordable coverage and the same insurance choices members of Congress will have. Exchanges
will help individuals and small employers shop for, select, and enroll in high quality, affordable
private health plans that fit their needs at competitive prices. The IT systems will support a
simple and seamless identification of people who qualify for coverage through the Exchange, tax
credits, cost-sharing reductions, Medicaid, and CHIP programs. By providing a place for onestop shopping, Exchanges will make purchasing health insurance easier and more understandable
and will put greater control and more choice in the hands of individuals and small businesses."
Read more about "Federalization" and workers' compensation:
(P.L. 111-148). On March 30, 2010, the Health Care and Education Reconciliation Act of 2010
(P.L. 111-152) was signed into law. The two laws are collectively referred to as the Affordable
Care Act. The Affordable Care Act creates new competitive private health insurance markets –
called Exchanges – that will give millions of Americans and small businesses access to
affordable coverage and the same insurance choices members of Congress will have. Exchanges
will help individuals and small employers shop for, select, and enroll in high quality, affordable
private health plans that fit their needs at competitive prices. The IT systems will support a
simple and seamless identification of people who qualify for coverage through the Exchange, tax
credits, cost-sharing reductions, Medicaid, and CHIP programs. By providing a place for onestop shopping, Exchanges will make purchasing health insurance easier and more understandable
and will put greater control and more choice in the hands of individuals and small businesses."
Read more about "Federalization" and workers' compensation:
Thursday, June 14, 2012
National Experts Call Workers Compensation System Irrational and Unjust
National workers' compensation experts, Law school Dean Emily A. Spieler and Professor John F. Burton, in a recently published article in the American Journal of Industrial Medicine conclude that the present that the present workers' compensation systems is "irrational" and "unjust."
Characterizing the program as "....dizzying and frustrating in its complexity, and apparent irrationality," they conclude that "a substantial proportion of persons with work-related disabilities do not receive workers' compensation benefits." They review such alternatives as universal medical care, "providing healthcare to workers regardless of the source of injuries or disease."
Related Articles on Alternative Compensation Programs
Dec 23, 2010
Yesterday the US Congress passed and sent to the President, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program. The Federally ...
Feb 15, 2011
In December 2010 US Congress passed and President Obama signed, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program.
Jul 05, 2010
The trend toward Federalization of workers' compensation benefits took a giant step forward by recent Presidential action creating the British Petroleum Oil Compensation Fund. While the details remain vague, the broad and ...
Jul 13, 2010
As The Path To Federalization expands, this debate will expand. A recent study by the Center for American Progress addresses these concerns. "Health threats from the oil spill may linger unseen, perhaps for more than a ...
Mar 16, 2011
Historically The Federal government's role has been to rise to the occasion and walk further down a path to federalization. On a smaller scale than the potential consequences of the Japanesse debacle, the US was first in line ...
Mar 05, 2011
Nationally, advocates to improve the delivery of medical benefits to injured workers have urged federalization of the medical delivery system into a single payer approach through universal health care. ... Compensation Claim Draws Major Public Attention (workers-compensation.blogspot.com); Vermont Governor Sets Out to Lead U.S. to True Universal Coverage (huffingtonpost.com); The World Trade Center Health Program Expands The Path to Federalization ...
Wednesday, March 16, 2011
A Nuclear Workers' Compensation Disaster
Historically The Federal government's role has been to rise to the occasion and walk further down a path to federalization. On a smaller scale than the potential consequences of the Japanesse debacle, the US was first in line in other mass disasters including: Beryllium workers, coal miners compensation, 9-11 Victims Compensation and subsequent Zadroga Fund, and the Gulf oil spill program. In the past the Feds have even prepared to help with H1N1 flu compensation and in the preparation of a Smallpox compensation program.
The Japanese model of delay and denial has proved ineffective. The victims of the Sumitomo Metal Mining uranium processing plant disaster in 1999 were summarily denied benefits for their ensuing radiation health problems.
While similar reactors in the US pose identical design problems, preparation is lacking in the US to provide an adequate response, and even integrate or utilize, the best of the state workers' compensation programs. Those systems are universally struggling to handle the delivery of benefits for occupational exposures. The Federal government has even ignored the implementation of legislation sponsored Senator Edward Markey (MA) for the prophylactic distribution of potassium iodine (KI) pills to those who are in a potential radius of exposure near nuclear reactor sites.
One would think that we would have learned from the Three Mile Island Diaster decades ago or Chernobyl (prediction of fatal cancers of 9,000 to 28,000 between 1986 and 2056). Even the warnings of leaks of similar nuclear reactors like Oyster Creek in NJ or Shoreham in NY, all close to major population centers, have not seemed to create a momentum of urgency.
Notoriously late to react in situations of latent disease has become the classic US policy. We have seen this repeated public health policy in other toxic exposures such as asbestos and tobacco. It is not that we didn't know, it is merely that the government just chose to ignore the public health issues. Unfortunately, this policy has compounded the problems for ailing workers' compensation systems, and it maybe too little and too late to prevent a meltdown of the entire system.
Monday, July 5, 2010
Designing the New Federal Workers Compensation Program
The trend toward Federalization of workers’ compensation benefits took a giant step forward by recent Presidential action creating the British Petroleum Oil Compensation Fund. While the details remain vague, the broad and sweeping concept of inclusiveness is more than obvious.
This is not a surprising turn of events. It is entirely consistent with a broad pattern to sweep the ailing and fragmented patch work of state programs into a unified Federal program. In an era of economic depression, national health care reform and major workforce changes this approach is consistent with the underlying bipartisan national philosophy.
Columnist and an expert in the field, Peter Rousemaniere, recently concluded an analysis of system’s failures that have literally pushed workers’ compensation into a federalized program. “The states and workers' compensation insurers have for decades weaseled on the promise to protect workers from occupational illnesses and to honor their claims.”
The knee jerk reaction, one would think, would be this could never happen because of interested stakeholders. In reality, they have been silently distracted by more far reaching issues and have been economically drained of resources to the point where they’ll take anything the Federal Government can offer to save them from extinction.
The Federal government is not unfamiliar with the administration and distribution of benefits. Since 1882 the federal government has been providing benefits to injured workers and their widows: in 1900 the postal workers compensation system was established; in 1908 the Federal government established a program for those who work in hazardous environments; and, in 1932 the Social Security Administration was established. However, the Social Security Act did not embrace workers’ compensation in 1932 since the primary goal of the law was to reduce unemployment.
The federal programs have produced a dismal result over the last few years. The Federal Victims Compensation Fund, enacted following the horrific tragedy of September 11th, 2001, has a very strict eligibility criteria and a limited recovery scheme. The Smallpox Emergency Personnel Protection Act of 2003 (SEPPA) was enacted following an aborted vaccination program after the government reluctantly disclosed available medical research concerning potential fatal cardiovascular reactions. A risk analysis demonstrated that this program may not have been needed at all but was merely implemented to sway public opinion. Ultimately, the federal government halted the Smallpox Vaccination Program and funded $100 million for the purpose of cleaning up the legacy of adverse medical reactions and to ease the burden placed upon the victims and their estates that were struggling to obtain benefits under State compensation programs.
The Energy Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA) (P.L.106-398) was enacted into law in October, 2000 with strong bipartisan support. EEOICPA established a program to provide compensation to employers of the Department of Energy (DOE), its contractors and subcontractors, companies that provided beryllium to DOE, and atomic weapons employers.
The Federal health care reform is a big Federal deal for workers’ compensation as it establishes the Libby Health Care Plan with far reaching impact by involving Medicare to deliver health care. The ongoing integration of conditional payments (Medicare Secondary Payer Act and mandatory reporting) as well as the review of all compromises concerning the provision of future medical care (Workers Compensation Medical Set-aside Agreements) is already anther Federal foot in the door to prevent what in the past was a tradeoff of medical care to US taxpayer without consideration.
While federalization may not be the panacea, the target remains to limit the cost of medical expenses and provide an efficient and remedial benefit delivery system at minimal cost for administration and to hold the appropriate parties financial responsible. The costs of maintaining duplicate medical delivery systems for workers, major medical and workers’ compensation, continues to represent an unnecessary and costly duplicate expenditures in administration and management.
The BP-Federal Oil Compensation Plan is yet another attempt to find a solution. While it may not be perfect, hopefully it will be guided successfully and will learn from past Federal trials and errors dabbling in workers’ compensation. It is obviously not the perfect solution, but that may only exist as an unattainable goal. The first step is a comprehensive and integrated Federal workers’ compensation program. A step in the right direction would be for the Federal Government to take primary responsibility for all occupational workers’ compensation claims. This would be an innovated initial approach to implement a new Federally administered Workers’ Compensation system.
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