Showing posts with label Medical Treatment. Show all posts
Showing posts with label Medical Treatment. Show all posts
Friday, February 26, 2021
Law Would Increase Transparency in the Workers’ Compensation Medical Delivery System
Senator Troy Singleton (NJ D-7) has introduced legislation that would increase transparency in medical treatment arising from workers’ compensation claims.
Sunday, February 23, 2020
NJ Cannabis Legal Protections Advance for Workers’ Compensation Medical Treatment
The NJ Assembly Financial Institutions and Insurance Committee reported favorably and with committee amendments Assembly Bill No. 377. As amended, this bill creates certain protections for insurers and insurance producers engaging in the business of insurance in connection with cannabis-related businesses.
Thursday, December 19, 2019
Judicial discretion
Just APPROVED FOR PUBLICATION 12/13/2019 a NJ Appellate case defining expectations and focussing on: judicial discretion, medical treatment and disallowed prescription opioids that do not ”cure and relieve.”
Sunday, May 5, 2019
Correct Way to Contest a Lien
Attorneys should follow the correct procedures to contest a lien asserted by a workers’ compensation insurance carrier. A recent case provides instructions on the appropriate techniques.
Tuesday, April 9, 2019
US FDA Moves to Further Regulate Marijuana Products
US Food and Drug Administration [FDA] announced a public hearing to obtain scientific data and information about the safety, manufacturing, product quality, marketing, labeling, and sale of products containing cannabis or cannabis-derived compounds.
Wednesday, April 3, 2019
Failure to Attend Employer Exam is Not Insubordination
A municipal who failed to attend a workers’ compensation medical appointment scheduled by his employer cannot be charged with subordination. N.J.A.C. 4A:2-2.3(a)(2), N.J.A.C. 2-2.3(a)(12).
Tuesday, March 26, 2019
Medical Treatment is an Exclusive Remedy Not a Reasonable Accommodation
The NJ Supreme Court has held that the provision of medical treatment does not equate to a "reasonable accommodation", therefore an employee cannot claim under the Law Against Discrimination [LAD] that failure to provide medical care was actionable. The provision of medical treatment is an exclusive remedy of the Workers’ Compensation Act.
Thursday, January 25, 2018
NJ Governor Murphy Signs Executive Order Mandating Review of Medical Marijuana Policy
NJ Governor Phil Murphy today signed an Executive Order directing the New Jersey Department of Health and the Board of Medical Examiners to review the state’s existing medical marijuana program. The goal of the review is to eliminate barriers to access for patients who suffer from illnesses that could be treated with medical marijuana.
Sunday, February 26, 2017
The limits on a total permanent disability award
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.
Friday, December 2, 2016
Victimizing Undocumented Injured Workers
NY TIMES QUOTATION OF THE DAY
"I was shot by terrorists, and it feels like the people I worked with are
victimizing me all over again."
VALERIE KALLIS-WEBER, 59, a victim of a mass shooting in San Bernardino, Calif., last year, on medical treatments that have been denied or delayed under the workers' compensation system that covers her care.
In New Jersey, "...without benefit of a legislative directive to the contrary, undocumented aliens are entitled to workers' compensation benefits. While undocumented aliens are not performing any illegal work, the court has reasoned that the New Jersey Workers' Compensation Act is not subject to any prohibitions similar to the unemployment law of each state which must comply with Federal standards; granting unemployment benefits to undocumented aliens would violate these standards."
Montoya v. Gateway Ins. Co., 168 N.J.Super. 100, 401 A.2d 1102 (App.Div.1979), certif. den. 81 N.J. 402, 408 A.2d 796 (1979). "The need for medical treatment is not a benefit derived from immigration status but rather from employment status. Mendoza v. Monmouth Recycling Corporation, 288 N.J.Super. 240, 672 A.2d 221 (App.Div.1996)." Gelman, Jon L., 38 N.J. Prac., Workers' Compensation Law § 11.8 (3d ed.).
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Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters).
For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com has been representing injured workers and their families who have suffered occupational accidents and illnesses.
Friday, March 18, 2016
NJ Judge Orders Psychotherapy Sessions In Conjunction With Pain Management
A NJ Workers' Compensation Judge Ordered the continuation of medical services to an injured worker who has been struggling for years because of chronic knee pain depression and anxiety despite the objection of the employer who sought to terminate care. The Judge Philip A. Tornetta, Administrative Supervisory Judge of Compensation, adopted an innovative approach in attempt to reduce or eliminated prescribed drugs including, "Oxycontin for her knee pain, Lexapro for depression and Xanax, which helps her sleep."
Wednesday, February 17, 2016
The State of Medical Care in California’s Workers’ Compensation System
 |
| Katherine Roe |
Todays' guest post is authored by Katie Roe* of the California Bar and was originally published at rivercityattorneys.com/blog (Fraulob & Brown).
When you’re injured at work, you expect that your employer’s insurance carrier will dutifully provide you with proper medical treatment for your injury. After all, future medical care is one of the “benefits” injured workers are entitled to in California. Denial of medical treatment is the number one frustration we hear from our clients on a daily basis.
What injured workers quickly discover is that their medical treatment is strictly controlled by the insurance carrier and their medical fate is in the hands of a doctor who has never treated them and may not even have their complete medical records. This process is called Utilization Review (UR). Under UR an outside physician gets to decide whether or not the insurance company should authorize the medical treatment prescribed by your primary treating physician. This doctor doesn’t even have to be licensed in California.
If the medical treatment prescribed by your physician is denied, your only recourse is to appeal the decision to an Independent Medical Reviewed (IMR). In California, MAXIMUS is the company contracted to conduct IMR reviews. Like UR doctors, the IMR doctor deciding your fate, has never met you or treated you and does not need to be licensed in California. In fact, their identity is protected. If your medical treatment is denied by UR, your chances of IMR overturning the decision are not good. California Workers’ Compensation Institute, an insurance research group, found that 91% of IMR decisions uphold the UR denial. If the treatment is denied by IMR, absent a change in circumstances, the denial will be in effect for one year.
While an injured worker has the right to appeal an IMR determination to the Workers’ Compensation Appeals Board, the only legal bases on which to appeal are fraud, conflict of interest, or mistake of fact. However, even if your appeal is successful the WCAB still cannot overturn the IMR doctor’s decision. If an appeal is granted, the remedy is referral to a different IMR for another review. Yes, you read that right, your award is to go through the IMR process again!
Many injured workers end up seeking treatment for their work related injuries through private insurance, Medicare or Medi-Cal. A study by J. Paul Leigh, a health economist at the University of California, Davis, estimated that only 1/3 of necessary medical treatment and lost wages is being paid for by workers’ compensation insurers.
The lack of adequate medical care for injured workers today is the result of Senate Bill 863, which was passed on August 1, 2012 and signed into law by Governor Brown on September 18, 2012. This law was the result of lobbying by big businesses and insurance companies, who have influence over the State Legislature and the Governor of California. We remind our clients that you also have a political voice. We recommend you go to Voters Injured at Work (www.viaw.org) for information on how to become involved with fixing this broken system.
To read more about the dismal state of medical treatment for injured workers all over America I encourage you to read Insult to Injury by Michael Grabell athttps://www.propublica.org/article/the-demolition-of-workers-compensation.
*Katherine Roe is originally from the San Francisco Bay Area. She attended University of St. Thomas, Saint Paul Minnesota for her undergraduate degree in Sociology with a minor in Criminal Justice. She earned her Master in Public Administration from University of Notre Dame de Namur, Belmont, CA. Katie graduated from University of the Pacific McGeorge School of Law in Sacramento where she received the Witkin Award for Health Law and Elder Law Clinic. She is a practicing attorney in the areas of Workers’ Compensation Law, Social Security Disability and Elder Law, including estate planning with wills, trusts, deeds, powers of attorney and health care directives.
While in college, Katie tutored grade school and high school students in low-income neighborhoods in Saint Paul and Minneapolis, MN and interned with the Oakdale, MN Police Department.
During law school, Katie interned with Legal Aid Society of San Mateo County, Human Rights Fair Housing Commission and the California Department of Insurance. While at McGeorge, she worked in the Elder and Health Law Clinic where she handled Medicare appeals, elder abuse cases, restraining orders, wills, trusts, consumer protection, special needs trusts, and powers of attorney.
While the Clinical Fellow at McGeorge she received the Cohn Sisters’ Scholarship for Patient Advocacy.
While in college, Katie tutored grade school and high school students in low-income neighborhoods in Saint Paul and Minneapolis, MN and interned with the Oakdale, MN Police Department.
During law school, Katie interned with Legal Aid Society of San Mateo County, Human Rights Fair Housing Commission and the California Department of Insurance. While at McGeorge, she worked in the Elder and Health Law Clinic where she handled Medicare appeals, elder abuse cases, restraining orders, wills, trusts, consumer protection, special needs trusts, and powers of attorney.
While the Clinical Fellow at McGeorge she received the Cohn Sisters’ Scholarship for Patient Advocacy.
Thursday, April 23, 2015
US FDA: Designation for CRS-207 in Mesothelioma Treatment
Today's post is shared from finance.yahoo.com/news
Aduro Biotech, Inc. today announced that the Office of Orphan Product Development of the U.S. Food and Drug Administration (FDA) has granted orphan drug designation to CRS-207, a novel immuno-oncology product candidate, for the treatment of mesothelioma. This designation potentially allows Aduro seven years of limited marketing exclusivity in the United States if it is the first to obtain FDA marketing approval for mesothelioma, and qualifies the company for grant funding to offset the cost of clinical testing as well as tax credits for certain research and a waiver of the Biologics License Application user fee. The FDA previously granted orphan designation to CRS-207 and GVAX Pancreas for the treatment of pancreatic cancer.
“This is an important step for Aduro as we continue to develop CRS-207 for this very difficult to treat cancer,” said Dirk Brockstedt, Ph.D., senior vice president of research and development at Aduro. “We believe the combination of CRS-207 together with chemotherapy may offer the promise of a potential new therapeutic regimen for patients suffering from mesothelioma. Importantly, we plan to report additional data from the ongoing Phase 1b study later this year.”
Click here to read the entire article
Aduro Biotech, Inc. today announced that the Office of Orphan Product Development of the U.S. Food and Drug Administration (FDA) has granted orphan drug designation to CRS-207, a novel immuno-oncology product candidate, for the treatment of mesothelioma. This designation potentially allows Aduro seven years of limited marketing exclusivity in the United States if it is the first to obtain FDA marketing approval for mesothelioma, and qualifies the company for grant funding to offset the cost of clinical testing as well as tax credits for certain research and a waiver of the Biologics License Application user fee. The FDA previously granted orphan designation to CRS-207 and GVAX Pancreas for the treatment of pancreatic cancer.
“This is an important step for Aduro as we continue to develop CRS-207 for this very difficult to treat cancer,” said Dirk Brockstedt, Ph.D., senior vice president of research and development at Aduro. “We believe the combination of CRS-207 together with chemotherapy may offer the promise of a potential new therapeutic regimen for patients suffering from mesothelioma. Importantly, we plan to report additional data from the ongoing Phase 1b study later this year.”
Click here to read the entire article
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Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thompson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson-Reuters). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
Sunday, December 14, 2014
California Medical Review: STEVENS WRIT GRANTED
| Containment of medical costs remain a major issue in all workers' compensation programs. The California process of "independent medical review" has turned into a nightmare for injured workers, their families and their advocates. The long awaited constitutional challenge to the process is slowly making its way through the California judicial system. Time will tell whether the judicial resolution will emerge as a solution to what was just terrible legislation. Today's post is authored by Julius Young and is shared from workerscompzone.com/ Could the California courts finally be ready to rule on the constitutionality of Independent Medical Review? We may be on the verge of seeing that issue decided. On December 3, 2014, the California Court of Appeal First Appellate District Division One granted the petition for writ of review filed San Francisco attorney Joseph Waxman on behalf of Frances Stevens (the case is Frances Stevens, Petitioner, v. WCAB and Outspoken Enterprises/State Compensation Insurance Fund ADJ1526353). In June 2014 the Court of Appeal had summarily denied a petition for a writ filed by Waxman in April 2014. At that time Waxman had not exhausted his administrative remedies. Waxman did so and then refiled for the writ, which was then granted. The basis facts in the case are important. Stevens had been found permanently and totally disabled (100%) by the workers’ comp judge. Her condition required use of a wheelchair and defendant had provided assistance by a home health aide.... |
Saturday, October 25, 2014
Doctors’ Recommended Treatment for Injured Workers is Denied 84% of the Time
Today's post is shared from Brett Gowen of the California Bar, Fraulob, Brown, Gowen & Snapp, a Professional Law Corporation
[Click here to see the rest of this post]
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Brett Gowen was born and raised in the Central Valley of California. He attended UC Davis for his undergraduate degree in Political Science with a minor in Economics. Brett graduated with distinction from University of the Pacific McGeorge School of Law in Sacramento. He practices Social Security law, Workers’ Compensation, and Elder Law, including estate planning with wills, trusts, deeds, powers of attorney, and conservatorships.
Sacramento, CA – The California Applicants’ Attorneys Association (CAAA), whose members represent Californians injured on the job, today continued its “What’s Wrong with this Picture?” series comparing quality health care measures in California workers’ compensation insurance to group health insurance. The fourth release compares the frequency of Independent Medical Review (IMR) decisions regarding denied medical treatment. The 800,000 workers’ compensation insurance patients appealed IMR treatment denials 60,776 times during a twelve-month period, while the vastly greater number of group health patients (16,000,000) filed just 1,558 appeals. This is one IMR decision for every 10,000 patients in group health vs. one for every 131 workers’ compensation patients. The IMR landslide of IMR appeals reflects a fundamental flaw in workers’ compensation: insurers send 3,500,000 doctors’ recommendations for care to their own Utilization Review (UR) companies each year. “Why do Californians hurt at work have to file 39 times as many IMR appeals of denied care as group health patients?” asked CAAA President Bernardo... |
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Brett Gowen was born and raised in the Central Valley of California. He attended UC Davis for his undergraduate degree in Political Science with a minor in Economics. Brett graduated with distinction from University of the Pacific McGeorge School of Law in Sacramento. He practices Social Security law, Workers’ Compensation, and Elder Law, including estate planning with wills, trusts, deeds, powers of attorney, and conservatorships.
Saturday, August 24, 2013
Health Law Adds New Expense For Farmers: Insurance For Field Workers
And while the requirement to cover workers was recently delayed until 2015, the contractors, who provide farmers with armies of field workers, say they are already preparing for the potential cost, inconvenience, and liability the new law will bring to their business, which typically operates on a slender profit margin.
"I've been to at least a dozen seminars on the Affordable Care Act since February," said Chuck Herrin, owner of Sunrise Farm Labor, a contractor based here. "If you don't take the right approach, you're wiped out."
The effects of the new law could be profound. Insurance brokers and health providers familiar with California's $43.5 billion agricultural industry estimate that meeting the law's minimum health plan will cost about $1 per hour per employee worked in the field.
Thursday, August 22, 2013
US Supreme Court Asked to Review MSP Preemption Issue
The US Supreme Court has been asked to review a claim on behalf of an injured worker who asserts that the Medicare Secondary Payer Act did not preempt State law (i.e.. Texas) that required a Workers' Compensation claimant to obtain preauthorization from relevant insurance carriers before incurring certain medical expenses. The Fifth Circuit Court of Appeals held that Medicare's conditional payment for a workers surgeries did not render the state law mandate for preauthorization requirements "moot."
A Writ of Certiorari was filed with the US Supreme Court on Aug. 8, 2012 and a response is due September 11, 2013
Guadalupe Caldera v. Insurance Company of the State of Pennsylvania, US Supreme Court Docket No. 12-40192. Case below, 716 F 3d 861, Docket No, 12-40192, 5th Cir Ct Appeals, Decided May 14, 2013.
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Jon L.Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
Sunday, August 4, 2013
Medicare To Punish 2,225 Hospitals For Excess Readmissions
As workers' compensation medical costs rise, the quality of care is a focus for Medicare. Medicare is focussing on hospital re-admissions in an effort to improve care and lower costs. This may have a trickle down effect on workers' compensation costs. Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org
Medicare will levy $227 million in fines against hospitals in every state but one for the second round of the government’s campaign to reduce the number of patients readmitted within a month, according to federal records released Friday.
Medicare identified 2,225 hospitals that will have payments reduced for a year starting on Oct. 1. Eighteen hospitals will lose 2 percent, the maximum possible and double the current top penalty.
Another 154 will lose 1 percent or more of every payment for a patient stay, the records show.
Medicare identified 2,225 hospitals that will have payments reduced for a year starting on Oct. 1. Eighteen hospitals will lose 2 percent, the maximum possible and double the current top penalty.
Another 154 will lose 1 percent or more of every payment for a patient stay, the records show.
Sunday, July 28, 2013
The Oklahoma Opt-Out System is Bad Medicine for an Ill System
The newly enacted Oklahoma "Opt-Out" workers' compensation system has been urged by reformers as an effort to provide a more efficient and effective than its century old program enacted in the early 1900s. A comparison of the Oklahoma Opt-Out system to the New Jersey system reflects a limitation on litigation and a return to a more administrative program. Additionally, the opt-out system would provide for injured workers' choice of physician that ultimately could be blended into an employer based health program.
The changes are dramatic, and a major shift from the traditional based system such as New Jersey has followed since 1911.
Obviously the future statics will be reviewed by all stakeholders to determine if the Opt-Out System can really satisfy the concerns of all stakeholders or just a few.
Radical statutory changes to workers' compensation that have been limited to the interests of specific interest groups in the past have been met with disasters. The Opt-Out System of Oklahoma appears to be one of those programs, and has been bitterly contested by the advocates of injured workers.
In order for the creation of an optimal system of compensation to meet the socio-political-economic changes that are occurring in the world, all parties must sit at the table and work out a plan together. The Oklahoma Opt-Out system just appears to be bad medicine for a very ill system.
The Jersey System:
Case are heard by Compensation Judges nominated by the Governor and the system is administered under the Executive Branch of government. There are 50 Compensation Judges.
The Oklahoma Opt-Out System:
Starting on February 1, an administrative process with three appointed commissioners will replace the current court procedure with 10 judges for litigating workers’ compensation claims.
Temporary Disability Benefits
The Jersey System:
If an injured worker is disabled for a period of more than seven days, he or she will be eligible to receive temporary total benefits at a rate of 70% their average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW. These benefits are provided during the period when a worker is unable to work and is under active medical care.The limit is 450 weeks. The maximum temporary disability rate for 2013 is $826.00.
Permanent Disability Benefits:
The Jersey System:
Partial Disability: When a job related injury or illness results in a partial permanent disability, benefits are based upon a percentage of certain "scheduled" or "non-scheduled" losses. A "scheduled" loss is one involving arms, hands, fingers, legs, feet, toes, eyes, ears or teeth. A "non-scheduled" loss is one involving any area or system of the body not specifically identified in the schedule, such as the back, the heart, the lungs. These benefits are paid weekly and are due after the date temporary disability ends.
Total Permanent Disability:
These weekly benefits are provided initially for a period of 450 weeks. These benefits continue beyond the initial 450 weeks provided that the injured worker is able to show that he or she remains unable to earn wages.
Wages earned after 450 weeks offset the weekly computation in proportion to the income at the time of the injury. Permanent Total benefits are paid weekly and are based upon 70% of the average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW.
Permanent Total Disability is also presumed when the worker has lost two major members or a combination of members of the body such as eyes, arms, hands, legs or feet. However, permanent total disability can also result from a combination of injuries that render the worker unemployable.
The changes are dramatic, and a major shift from the traditional based system such as New Jersey has followed since 1911.
Obviously the future statics will be reviewed by all stakeholders to determine if the Opt-Out System can really satisfy the concerns of all stakeholders or just a few.
Radical statutory changes to workers' compensation that have been limited to the interests of specific interest groups in the past have been met with disasters. The Opt-Out System of Oklahoma appears to be one of those programs, and has been bitterly contested by the advocates of injured workers.
In order for the creation of an optimal system of compensation to meet the socio-political-economic changes that are occurring in the world, all parties must sit at the table and work out a plan together. The Oklahoma Opt-Out system just appears to be bad medicine for a very ill system.
New Jersey Traditional v Oklahoma Opt-Out
Hearing OfficialsThe Jersey System:
Case are heard by Compensation Judges nominated by the Governor and the system is administered under the Executive Branch of government. There are 50 Compensation Judges.
The Oklahoma Opt-Out System:
Starting on February 1, an administrative process with three appointed commissioners will replace the current court procedure with 10 judges for litigating workers’ compensation claims.
Temporary Disability Benefits
The Jersey System:
If an injured worker is disabled for a period of more than seven days, he or she will be eligible to receive temporary total benefits at a rate of 70% their average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW. These benefits are provided during the period when a worker is unable to work and is under active medical care.The limit is 450 weeks. The maximum temporary disability rate for 2013 is $826.00.
The Oklahoma Opt-Out System:
Temporary disability payments will be reduced to 104 weeks instead of 156 weeks, with a cap at 70 percent of the state’s average weekly wage, about $540 per week.
Temporary disability payments will be reduced to 104 weeks instead of 156 weeks, with a cap at 70 percent of the state’s average weekly wage, about $540 per week.
Permanent Disability Benefits:
The Jersey System:
Partial Disability: When a job related injury or illness results in a partial permanent disability, benefits are based upon a percentage of certain "scheduled" or "non-scheduled" losses. A "scheduled" loss is one involving arms, hands, fingers, legs, feet, toes, eyes, ears or teeth. A "non-scheduled" loss is one involving any area or system of the body not specifically identified in the schedule, such as the back, the heart, the lungs. These benefits are paid weekly and are due after the date temporary disability ends.
Total Permanent Disability:
These weekly benefits are provided initially for a period of 450 weeks. These benefits continue beyond the initial 450 weeks provided that the injured worker is able to show that he or she remains unable to earn wages.
Wages earned after 450 weeks offset the weekly computation in proportion to the income at the time of the injury. Permanent Total benefits are paid weekly and are based upon 70% of the average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW.
Permanent Total Disability is also presumed when the worker has lost two major members or a combination of members of the body such as eyes, arms, hands, legs or feet. However, permanent total disability can also result from a combination of injuries that render the worker unemployable.
The Oklahoma Opt-Out System:
Permanent disability payments will be reduced from 520 weeks to 350 weeks.
Choice of Treating Physician
The Jersey System:
The Jersey System:
None. Employer selected physician must be utilized.
The Oklahoma Opt-Out System:
Employees will be allowed to change treating physicians once so long as the selection is from a list of three doctors provided by the employer.
Arbitration or Alternate Dispute Resolution
The Jersey System:
None. All cases, including settlements, must be heard or reviewed by a Compensation Judge.
The Oklahoma Opt-Out System:
Employers can require arbitration as the exclusive way to settle claims and disputes with employees.
Tuesday, July 23, 2013
Hospitals May Soon Be Reaching For The Stars
Should injured workers have the opportunity to select the "best rated" medical provider? The Federal government is looking forward to providing outcome base rating information. The workers' compensation system should utilize that information and allow injured workers to be able make an educated choice in seeking medical care. Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org
Star wars may be coming to a hospital near you.
Medicare is considering assigning stars or some other easily understood symbol to hospitals so patients can more easily compare the quality of care at various institutions. The ratings would appear on Medicare’s Hospital Compare website and be based on many of the 100 quality measures the agency already publishes.
The proposal comes as Medicare confronts a paradox: Although the number of ways to measure hospital performance is increasing, those factors are becoming harder for patients to digest. Hospital Compare publishes a wide variety of details about medical centers, including death rates, patient views about how well doctors communicated, infection rates for colon surgery and hysterectomies, emergency room efficiency and overuse of CT scans.
In its proposed rules for hospitals in the fiscal year starting Oct. 1, the Centers for Medicare & Medicaid Services asked for ideas about "how we may better display this information on the Hospital Compare Web site. One option we have considered is aggregating measures in a graphical display, such as star ratings."
Private groups such as Consumer Reports, the Leapfrog Group and US News and World Report already issue hospital guides that boil down the disparate Medicare scores -- along with their own proprietary formulas -- to come up with numeric scores, letter grades or rankings.
But even before it's formally proposed, the possibility of the government rating...
[Click here to see the rest of this article]Medicare is considering assigning stars or some other easily understood symbol to hospitals so patients can more easily compare the quality of care at various institutions. The ratings would appear on Medicare’s Hospital Compare website and be based on many of the 100 quality measures the agency already publishes.
The proposal comes as Medicare confronts a paradox: Although the number of ways to measure hospital performance is increasing, those factors are becoming harder for patients to digest. Hospital Compare publishes a wide variety of details about medical centers, including death rates, patient views about how well doctors communicated, infection rates for colon surgery and hysterectomies, emergency room efficiency and overuse of CT scans.
In its proposed rules for hospitals in the fiscal year starting Oct. 1, the Centers for Medicare & Medicaid Services asked for ideas about "how we may better display this information on the Hospital Compare Web site. One option we have considered is aggregating measures in a graphical display, such as star ratings."
Private groups such as Consumer Reports, the Leapfrog Group and US News and World Report already issue hospital guides that boil down the disparate Medicare scores -- along with their own proprietary formulas -- to come up with numeric scores, letter grades or rankings.
But even before it's formally proposed, the possibility of the government rating...
...
For over 3 decades the Law Offices of Jon L. Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
Read more about "medical treatment" and workers' compensation:
Apr 15, 2013
The main difference is in Nebraska, as long as the worker elects a prior treating doctor to treat their injury (for example, the worker's family doctor), that doctor can dictate the medical care and refer them to others for treatment.
May 18, 2013
While workers' compensation insurance carriers may set approved fees or contract with providers, hospitals have huge disparities in the cost for medical care provided. Additionally, there appears to be no difference in the ...
Nov 16, 2012
New York Worker's Compensation Board's proposed new medical treatment guidelines that will modify 2010 previously implemented. Adopt the new carpal tunnel syndrome (CTS) medical treatment guidelines (MTG) as the ...
Jul 03, 2013
Read more about The Affordable Health Care Act: Workers' Compensation: Protecting Healthcare Workers. May 06, 2013. Kerri A. Thom, MD, MS, Assistant Professor of Medicine at the University of Maryland School of ...
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