The New Jersey Supreme Court recently heard oral argument concerning the mathematical limits of a workers’ compensation total disability case. At the heart of the case is the issue of whether an injured worker could have an increase in a pre-existing permanent partial disability [PPT] claim, that existed prior to the last compensable injury which was to another part of the body. The last compensable claim rendered the worker totally and permanently disabled.
Showing posts with label Medicaid. Show all posts
Showing posts with label Medicaid. Show all posts
Sunday, February 26, 2017
Thursday, February 16, 2017
The Consequences of TrumpMedical 2016–25: Price Increases, Aging Push Sector To 20 Percent Of Economy
Workers' Compensation medical expenses mirror some of the national health care projections. An aging workforce and the increased longevity of the population impacts overall all costs. Furthermore as the Affordable Healthcare Act's repeal has been anticipated by the Republican Administration, medical care costs are anticipated to spiral. The draft release of the Republican proposal for a new national medical care system is now being revealed.
Directly and indirectly, workers' compensation coverage will feel the impact. For chronic condition denials, pre-existing condition denials and occupational disease denials, the safety net of Medicaid will be diminished and the workers' compensation system will again be the primary target for payment and litigation will increase logarithmically.
Saturday, July 19, 2014
Medical Errors - The Third Leading Cost of Death
Medical doctors specializing in patient safety testified on preventable medical errors that can lead to death or serious financial problems as bills mount to correct the medical mistake.
Thursday, June 26, 2014
What Impact Will Hepatitis C Drugs Have on Medical Costs? Look Here
| Just what impact will hepatitis C treatments have on medical spending over the next few years? The answer to this question has been the subject of heated debate thanks to the Sovaldi treatment sold by Gilead Sciences . The medication can cure 90 percent of the patients who have the most common form of the affliction, and costs $1,000 a day for a 12-week course, or $84,000 for one patient. Medications for other diseases may be more expensive, but insurers worry about the potential outlay, given that approximately 3.2 million people in the U.S. are chronically infected with hepatitis C, according to the U.S. Center for Disease Prevention and Control. Some estimates suggest the number is closer to 5 million. For months, state Medicaid programs and private payers have blanched at the cost. Other drug makers hope to catch up to Gilead in the race to develop a still more effective and convenient treatment that works even faster. But it remains unclear to what extent a price war may ensue. Meanwhile, concerns mount these medicines will, collectively, become budget busters. Of course, there is another way to view the issue, which is that the cost of treating patients who may otherwise need countless physician visits, hospital care and a liver transplant can run higher.... |
Wednesday, December 11, 2013
More Cost Shifting
A recent study reports that zero-cost workers' compensation claims merely creates cost shifting to other programs.
Objective: Previous research suggests that non–workers' compensation (WC) insurance systems, such as group health insurance (GHI), Medicare, or Medicaid, at least partially cover work-related injury and illness costs. This study further examined GHI utilization and costs.
Methods: Using two-part model, we compared those outcomes immediately after injuries for which accepted WC medical claims made zero or positive medical payments.
Results: Controlling for pre-injury GHI utilization and costs and other covariates, our results indicated that post-injury GHI utilization and costs increased regardless of whether a WC medical claim was zero or positive. The increases were highest for zero-cost WC medical claims.
Conclusion: Our national estimates showed that zero-cost WC medical claims alone could cost the GHI $212 million per year.
Thursday, December 5, 2013
President Obama Statement on the Benefits of the Affordable Care Act
Thanks to Monica, thanks to everybody standing behind me, and thanks for everybody out there who cares deeply about this issue. Monica’s story is important because for all the day-to-day fights here in Washington around the Affordable Care Act, it’s stories like hers that should remind us why we took on this reform in the first place.
And for too long, few things left working families more vulnerable to the anxieties and insecurities of today’s economy than a broken health care system. So we took up the fight because we believe that, in America, nobody should have to worry about going broke just because somebody in their family or they get sick. We believe that nobody should have to choose between putting food on their kids’ table or taking them to see a doctor. We believe we’re a better country than a country where we allow, every day, 14,000 Americans to lose their health coverage; or where every year, tens of thousands of Americans died because they didn’t have health care; or where out-of-pocket costs drove millions of citizens into poverty in the wealthiest nation on Earth. We thought we were better than that, and that’s why we took this on. (Applause.)
And that’s what’s gotten lost a little bit over the last couple of months. And our focus, rightly, had to shift towards working 24/7 to fix the website, healthcare.gov, for the new marketplaces where people can buy affordable insurance plans. And today, the website is working well for the vast majority of users. More problems may pop up, as they always do when you’re launching something new. And when they do, we’ll fix those, too. But what we also know is that after just the first month, despite all the problems in the rollout, about half a million people across the country are poised to gain health care coverage through marketplaces and Medicaid beginning on January 1st -- some for the very first time. We know that -- half a million people. (Applause.) And that number is increasing every day and it is going to keep growing and growing and growing, because we know that there are 41 million people out there without health insurance. And we know there are a whole bunch of folks out there who are underinsured or don’t have a good deal. And we know the demand is there and we know that the product on these marketplaces is good and it provides choice and competition for people that allow them, in some cases for the very first time, to have the security that health insurance can provide.
The bottom line is this law is working and will work into the future. People want the financial stability of health insurance. And we’re going to keep on working to fix whatever problems come up in any startup, any launch of a project this big that has an impact on one-sixth of our economy, whatever comes up we’re going to just fix it because we know that the ultimate goal, the ultimate aim, is to make sure that people have basic security and the foundation for the good health that they need.
Now, we may never satisfy the law’s opponents. I think that’s fair to say. Some of them are rooting for this law to fail -- that’s not my opinion, by the way, they say it pretty explicitly. (Laughter.) Some have already convinced themselves that the law has failed, regardless of the evidence. But I would advise them to check with the people who are here today and the people that they represent all across the country whose lives have been changed for the better by the Affordable Care Act.
The other day I got a letter from Julia Walsh in California. Earlier this year, Julia was diagnosed with leukemia and lymphoma. “I have a lot of things to worry about,” she wrote. “But thanks to the [Affordable Care Act], there are lots of things I do not have to worry about, like…whether there will be a lifetime cap on benefits, [or] whether my treatment will bankrupt my family…I can’t begin to tell you how much that peace of mind means...” That’s what the Affordable Care Act means to Julia. She already had insurance, by the way, but because this law banned lifetime limits on the care you or your family can receive, she’s never going to have to choose between providing for her kids or getting herself well -- she can do both.
Sam Weir, a doctor in North Carolina, emailed me the other day. “The coming years will be challenging for all of us in family medicine,” he wrote. “But my colleagues and I draw strength from knowing that beginning with the new year the preventive care many of our current patients have been putting off will be covered and the patients we have not yet seen will finally be able to get the care that they have long needed.” That’s the difference that the Affordable Care Act will make for many of Dr. Weir’s patients. Because more than 100 million Americans with insurance have gained access to recommended preventive care like mammograms, or colonoscopies, or flu shots, or contraception to help them stay healthy -- at no out-of-pocket cost. (Applause.)
At the young age of 23, Justine Ula is battling cancer for the second time. And the other day, her mom, Joann, emailed me from Cleveland University Hospital where Justine is undergoing treatment. She told me she stopped by the pharmacy to pick up Justine’s medicine. If Justine were uninsured, it would have cost her $4,500. But she is insured -- because the Affordable Care Act has let her and three million other young people like Monica gain coverage by staying on their parents’ plan until they’re 26. (Applause.) And that means Justine’s mom, all she had to cover was the $25 co-pay.
Because of the Affordable Care Act, more than 7 million seniors and Americans with disabilities have saved an average of $1,200 on their prescription medicine. (Applause.) This year alone, 8.5 million families have actually gotten an average of $100 back from their insurance company -- you don’t hear that very often -- (laughter) -- because it spent too much on things like overhead, and not enough on their care. And, by the way, health care costs are rising at the slowest rate in 50 years. So we’re actually bending the cost of health care overall, which benefits everybody. (Applause.)
So that’s what this law means to millions of Americans. And my main message today is: We’re not going back. We’re not going to betray Monica, or Julia, or Sam, or Justine, or Joann. (Applause.) I mean, that seems to be the only alternative that Obamacare’s critics have is, well, let’s just go back to the status quo -- because they sure haven’t presented an alternative. If you ask many of the opponents of this law what exactly they’d do differently, their answer seems to be, well, let’s go back to the way things used to be.
Just the other day, the Republican Leader in the Senate was asked what benefits people without health care might see from this law. And he refused to answer, even though there are dozens in this room and tens of thousands in his own state who are already on track to benefit from it. He just repeated “repeal” over and over and over again. And obviously we’ve heard that from a lot of folks on that side of the aisle.
Look, I’ve always said I will work with anybody to implement and improve this law effectively. If you’ve got good ideas, bring them to me. Let’s go. But we’re not repealing it as long as I’m President and I want everybody to be clear about that. (Applause.)
We will make it work for all Americans. If you don’t like this law -- (applause) -- so, if despite all the millions of people who are benefitting from it, you still think this law is a bad idea then you’ve got to tell us specifically what you’d do differently to cut costs, cover more people, make insurance more secure. You can’t just say that the system was working with 41 million people without health insurance. You can’t just say that the system is working when you’ve got a whole bunch of folks who thought they had decent insurance and then when they got sick, it turned out it wasn’t there for them or they were left with tens of thousands of dollars in out-of-pocket costs that were impossible for them to pay.
Right now, what that law is doing -- (baby talks.) Yes, you agree with me. (Laughter.) Right now, what this law is doing is helping folks and we’re just getting started with the exchanges, just getting started with the marketplaces. So we’re not going to walk away from it. If I’ve got to fight another three years to make sure this law works, then that’s what I’ll do. That’s what we’ll do. (Applause.)
But what’s important for everybody to remember is not only that the law has already helped millions of people but that there are millions more who stand to be helped. And we’ve got to make sure they know that. And I’ve said very clearly that our poor execution in the first couple months on the website clouded the fact that there are a whole bunch of people who stand to benefit. Now that the website is working for the vast majority of people, we need to make sure that folks refocus on what’s at stake here, which is the capacity for you or your families to be able to have the security of decent health insurance at a reasonable cost through choice and competition on this marketplace and tax credits that you may be eligible for that can save you hundreds of dollars in premium costs every month, potentially.
So we just need people to -- now that we are getting the technology fixed -- we need you to go back, take a look at what’s actually going on, because it can make a difference in your lives and the lives of your families. And maybe it won’t make a difference right now if you’re feeling healthy, but I promise you, if somebody in your family -- heaven forbid -- gets sick, you’ll see the difference. And it will make all the difference for you and your families.
So I’m going to need some help in spreading the word -- I’m going to need some help in spreading the word. I need you to spread the word about the law, about its benefits, about its protections, about how folks can sign up. Tell your friends. Tell your family. Do not let the initial problems with the website discourage you because it’s working better now and it’s just going to keep on working better over time. Every day I check to make sure that it’s working better. (Laughter.) And we’ve learned not to make wild promises about how perfectly smooth it’s going to be at all time, but if you really want health insurance through the marketplaces, you’re going to be able to get on and find the information that you need for your families at healthcare.gov.
So if you’ve already got health insurance or you’ve already taken advantage of the Affordable Care Act, you’ve got to tell your friends, you’ve got to tell your family. Tell your coworkers. Tell your neighbors. Let’s help our fellow Americans get covered. Let’s give every American a fighting chance in today’s economy.
Thank you so much, everybody. God bless you. God bless America. (Applause.)
Tuesday, December 3, 2013
Better Pay Now
’Tis the season to be jolly — or, at any rate, to spend a lot of time in shopping malls. It is also, traditionally, a time to reflect on the plight of those less fortunate than oneself — for example, the person on the other side of that cash register.
The last few decades have been tough for many American workers, but especially hard on those employed in retail trade — a category that includes both the sales clerks at your local Walmart and the staff at your local McDonald’s. Despite the lingering effects of the financial crisis, America is a much richer country than it was 40 years ago. But the inflation-adjusted wages of nonsupervisory workers in retail trade — who weren’t particularly well paid to begin with — have fallen almost 30 percent since 1973.
So can anything be done to help these workers, many of whom depend on food stamps — if they can get them — to feed their families, and who depend on Medicaid — again, if they can get it — to provide essential health care? Yes. We can preserve and expand food stamps, not slash the program the way Republicans want. We can make health reform work, despite right-wing efforts to undermine the program.
And we can raise the minimum wage.
First, a few facts. Although the national minimum wage was raised a few years ago, it’s still very low by historical standards, having consistently lagged behind both inflation and average wage levels. Who gets...
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Sunday, November 17, 2013
California sends misinformation to 246,000 new Medicaid enrollees
LOS ANGELES -- California has mistakenly sent letters to 246,000 low-income residents, warning they may need to find new doctors next year under the state's newly expanded Medicaid program.
The error frustrated counties and community health centers, which have repeatedly assured patients they can keep their providers when the Affordable Care Act takes effect in 2014. The patients are part of the state's "bridge to reform" program, which was designed to cover uninsured, poor Californians until they became eligible for Medicaid, known as Medi-Cal here. The program launched in 2011 and more than 600,000 people across the state enrolled in county-based health coverage. Many of them formed relationships with doctors and started seeking regular care. But county and clinic administrators said the incorrect mailing this month has put the counties' efforts in jeopardy. The mix-up occurred as people are scrambling to figure out how the health law impacts them, and as private policy holders have been receiving letters canceling their insurance plans. "The whole key to the success is that people seamlessly transition to Medi-Cal," said Sean South, an associate director at the California Primary Care Association. "It is vitally important that we don't confuse them." But that's what happened when the incorrect letters started going out on Nov. 1, said clinic and county officials. Patients immediately began calling and showing up with questions about the letter, said Eva Serrano, a... |
Wednesday, November 13, 2013
Professionalism and Caring for Medicaid Patients — The 5% Commitment?
 Physicians have good reasons for not accepting Medicaid patients, as I learned from direct experience as a member of a nine-physician primary care practice in California. We accepted Medicaid patients, but it was difficult. Medicaid's payment rate was very low — we lost money on each Medicaid visit. When referrals were necessary, we often had to personally ask specialists to accept our patient.... |
Monday, November 11, 2013
Worried About Costs And Unaware of Help, Californians Head Into New Era of Health Coverage
Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org
As uninsured Californians head into a new era of health coverage, they're worried about costs and unaware of the help they'll get from the government, a new survey finds.
The survey, by the Kaiser Family Foundation, found that three out of four Californians who earn modest incomes and could buy government-subsidized private coverage believe, wrongly, that they're not eligible for federal assistance or they simply don't know if they qualify.  "This has been, for so long, a political debate," said Anthony Wright, executive director of Health Access, a Sacramento-based consumer advocacy group. "We're just starting to move it into a practical reality. Now that the benefits are close at hand, there is a concerted effort to educate people about what their benefits are." California is one of two dozen states preparing to dramatically expand Medicaid, the federal-state insurance program for the poor, yet the survey found only half of newly eligible low-income Californians presume they will qualify. The nonpartisan Kaiser Family Foundation surveyed some 2,000 uninsured Californians from mid-July until the end of August, a summertime lull before a burst of... |
Tuesday, October 22, 2013
McDonald's Profit Is Awkwardly Close To What It Costs Taxpayers Every Year
McDonald's announced Monday that it raked in $1.5 billion in profits in the third quarter, up 5 percent from last year.
The number is strikingly close to the $1.2 billion taxpayers are shelling out each year to help pay public assistance to the McDonald's workforce, according to a report released last week by the National Employment Law Project.  The echoing numbers are simply a coincidence, but underscore the immense profits that the chain continues to pull in while its workers simply struggle to afford food, medical help and housing. The public assistance McDonald's workers receive comes via food stamps, welfare, Medicaid and other federal programs, according to the NELP report.In a statement to The Huffington Post, McDonald's emphasized that workers get training and the opportunity for career advancement. The company also said that its franchisees pay competitive wages that are based on "local wage laws." Those wages are stunningly low. Frontline fast-food workers make a median wage of $8.94 an hour, according to a recent Reuters report. "Fast-food workers work only 24 hours a week on average — at $8.94 an hour, this adds up to barely $11,000 a year," wrote Christine Owens for Reuters in August. With wages that low, front-line fast food workers are more than twice as likely as the typical worker to participate in a government assistance program, according to the NELP report: |
Lousy Medicaid Arguments
For now, the big news about Obamacare is the debacle of HealthCare.gov, the Web portal through which Americans are supposed to buy insurance on the new health care exchanges. For now, at least, HealthCare.gov isn’t working for many users.
It’s important to realize, however, that this botch has nothing to do with the law’s substance, and will get fixed. After all, a number of states have successfully opened their own exchanges, doing for their residents exactly what the federal system is supposed to do everywhere else. Connecticut’s exchange is working fine, as is Kentucky’s. New York, after some early problems, seems to be getting there. So, a bit more slowly, does California.
In other words, the technical problems, while infuriating — heads should roll — will not, in the end, be the big story. The real threat remains the effort of conservative groups to sabotage reform, especially by blocking the expansion of Medicaid. This effort relies heavily on lobbying, lavishly bankrolled by the usual suspects, including the omnipresent Koch brothers. But it’s not just money: the right has also rolled out some really lousy arguments.
And I don’t just mean lousy as in “bad”; I also mean it in the original sense, “infested with lice.”
Before I get there, a word about something that, as far as we can tell, isn’t happening. Remember “rate shock”? A few months ago it was all the rage in...
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Friday, October 18, 2013
Labor puts Dems on notice: Don’t touch Medicare and Social Security benefits
With the crisis chatter in Washington now turning to speculation about the coming budget talks and the possibility of a “grand bargain” to replace the sequester, liberals and unions are getting increasingly nervous that Congressional Dems will give up entitlement benefits cuts in exchange for, well, whatever is on offer from Republicans, which isn’t at all clear.
In an interview, Damon Silvers, the policy director of the AFL-CIO, laid down a hard line, putting Dems on notice that any agreement that cuts entitlement benefits — even in a deal that includes GOP concessions on tax hikes — is a nonstarter. Silvers strongly suggested labor would withhold support in 2014 from any Dem lawmaker who supports such a deal. “We are opposed to Social Security, Medicare, and Medicaid benefits cuts. Period,” Silvers told me. “There will be no cover for members of either party who vote for such a thing.” Silvers said the AFL-CIO also opposes the entitlements cuts in the President’s budget, such as Chained CPI and a form of Medicare means testing. It’s unclear how, or whether, those will figure in what Dems bring to the table in the budget talks, which are mandated by the deal just reached to end the crisis. “Chained CPI is like the vampire of American politics,” Silvers said. “It keeps being shot through the heart and it keeps reviving. The reason it keeps coming back is because it has... |
Wednesday, October 9, 2013
Federal Court Deems CMS Interpretation of the MSP Act Impenetrable
A UD District Court has denied a health provider's challenge to CMS's interpretation of the to the Medicare Secondary Act. CMS's formula for reimbursement was upheld.
"The Court finds this line of argument unpersuasive for several reasons. Most significantly, Allina's heavy reliance on the above-cited cases is unavailing because none of those decisions directly dealt with the precise issue before this Court–i.e., the phrase “entitled to benefits under Part A.” Rather, all of those courts were called upon to interpret the other component of the Medicaid fraction's numerator–the requirement that patients be “eligible” for Medicaid. For this very reason, our Court of Appeals “declined to follow” those same cases, characterizing those courts' discussion of the phrase “entitled to benefits” as dicta. Northeast Hosp., 657 F.3d at 12 n.7. This Court agrees with that assessment and follows the lead of our Circuit. Those decisions do not lend any meaningful support to Allina's arguments here. Moreover, the D.C. Circuit has rejected the substance of this “eligible” versus “entitled” argument as unpersuasive in any event, observing in Northeast Hospital that “the fact that the DSH factions speak of ‘eligibility’ for Medicaid but ‘entitlement’ to Medicare” was not “enlightening.” Id. at 12. Instead, as the Circuit went on to state, “the Secretary's interpretation of ‘entitled’ as ‘meeting the statutory criteria for entitlement’ ... does not actually collapse the terms.” Id. (explaining that an individual could be “ ‘eligible’ for, but not ‘entitled’ to, Part A benefits because one has not yet ‘enrolled’ in the program”). This Court concurs. The Secretary's reading of the statute at issue here does not equate these two terms, and Allina's insistence otherwise lacks merit."
"The Court finds this line of argument unpersuasive for several reasons. Most significantly, Allina's heavy reliance on the above-cited cases is unavailing because none of those decisions directly dealt with the precise issue before this Court–i.e., the phrase “entitled to benefits under Part A.” Rather, all of those courts were called upon to interpret the other component of the Medicaid fraction's numerator–the requirement that patients be “eligible” for Medicaid. For this very reason, our Court of Appeals “declined to follow” those same cases, characterizing those courts' discussion of the phrase “entitled to benefits” as dicta. Northeast Hosp., 657 F.3d at 12 n.7. This Court agrees with that assessment and follows the lead of our Circuit. Those decisions do not lend any meaningful support to Allina's arguments here. Moreover, the D.C. Circuit has rejected the substance of this “eligible” versus “entitled” argument as unpersuasive in any event, observing in Northeast Hospital that “the fact that the DSH factions speak of ‘eligibility’ for Medicaid but ‘entitlement’ to Medicare” was not “enlightening.” Id. at 12. Instead, as the Circuit went on to state, “the Secretary's interpretation of ‘entitled’ as ‘meeting the statutory criteria for entitlement’ ... does not actually collapse the terms.” Id. (explaining that an individual could be “ ‘eligible’ for, but not ‘entitled’ to, Part A benefits because one has not yet ‘enrolled’ in the program”). This Court concurs. The Secretary's reading of the statute at issue here does not equate these two terms, and Allina's insistence otherwise lacks merit."
Allina Health System v. Sebelius,
--- F.Supp.2d ----, 2013 WL 5530609, D.D.C., October 08, 2013 (NO. 09-CV-1889 (RLW))
Monday, September 23, 2013
State Politics and the Fate of the Safety Net
Only 2% of acute care hospitals nationwide are safety-net facilities, but they provide 20% of uncompensated care to the uninsured. Because most are in low-income communities, they typically generate scant revenue from privately insured patients. The Medicaid Disproportionate Share Hospital (DSH) program was established to help defray their costs for uncompensated care. Currently, Medicaid DSH disburses $11.5 billion annually to the states, which have considerable latitude in allocating these funds. Some states carefully target their DSH payments to hospitals providing large volumes of uncompensated care, but others, such as Ohio and Georgia, spread their payments broadly, transforming the program into a de facto subsidy of their hospital industry. Because the Affordable Care Act (ACA) was expected to dramatically expand insurance coverage, safety-net hospitals were expected to need less DSH money. Therefore, to reduce the cost of expanding Medicaid, the ACA reduced Medicaid DSH funding by $18.1 billion between fiscal years 2014 and 2020. To allow time for coverage expansion to take effect, the cuts are back-loaded — starting at $500 million (4% of current national DSH spending) in 2014 but reaching $5.6 billion (49% of current spending) in 2019. The DSH cuts are so deep in part because Congress assumed that all... |
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Thursday, September 12, 2013
Getting While the Getting Is Good
 “Don’t wait for a crisis,” I told another friend, his mother recently widowed, lonely and overwhelmed, rattling around in a family house that was now her solo responsibility. “Don’t wait for a crisis,” I told a third friend, whose widowed father-in-law dropped his daily insulin regimen after his live-in girlfriend left him. “Don’t wait for a crisis,” I’ve told readers of “The New Old Age,” no doubt ad nauseam. As just about everyone who has cared for an aging parent knows, getting old is both an inexorable and maddeningly unpredictable forward march. Everything is OK. Then it’s not. Then it is again. What felt early on like a roller coaster becomes the new normal. In between swerves and plummets, it is almost possible to doze off. And planning for all possible eventualities is useless — after the essential documents are in place, the family has talked openly and often about end-of-life wishes, they understand the difference between Medicare and Medicaid, they know how much money is available and that it is probably not going to be enough. Caregivers and their elderly charges both know, in a spoken or unspoken way, that on the horizon is The Crisis. That’s the one that demarcates “before” and “after.” Your parents... |
Tuesday, September 10, 2013
Law Will Shift Demographics For Medicaid Toward Healthier Group, Study Finds
The health law is expected to change the face of Medicaid – literally. Using statistics from the National Health and Nutrition Examination Survey, the authors found that the group of newly eligible individuals is:
“It’s really a game changer,” said Dr. Tammy Chang, a lead author of the report. “A lot of providers think of Medicaid... |
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