Copyright
Friday, May 29, 2009
Opposition Mounts to a National Study Commission
“This is a typical Washington D.C. approach: appoint a commission, give it a big budget and create a big new bureaucracy,” said PIA National Government Affairs Committee Chairman Johnny Lee. “The fact is, none of this is necessary. Workers’ compensation programs are regulated by the states, not the federal government. The federal government should not seek to interfere in a state-based and state-regulated system. This is a waste of time and taxpayers dollars.”
Monday, June 17, 2013
Proposed Medicare Payment Reductions Will Impact Workers' Compensation Costs
The Medicare Payment Advisory Commission (MedPAC) releases its June 2013 Report to the Congress:
Medicare and the Health Care Delivery System.
According to Commission Chair Glenn Hackbarth, “This report can inform a dialogue about future
directions for the Medicare program, as well as about technical refinements to existing Medicare
payment policy. Whether broad or narrow, the Commission’s work aims to balance the interests of
Medicare beneficiaries, health care providers, and tax payers.”
Redesigning the Medicare benefit. In the report, the Commission continues its discussion of
possible ways to redesign the Medicare benefit by focusing on the concept we refer to as competitively
determined plan contributions (CPC). Under CPC, Medicare beneficiaries could receive care through
either a private plan or traditional fee-for-service (FFS), but the premium paid by the beneficiary might
vary depending on the coverage option they choose. How much the federal government pays for a
beneficiary’s care would be determined through a competitive process comparing the costs of available
options for coverage. The report identifies key issues to be addressed if the Congress wishes to pursue a
policy option like CPC. These include how benefits could be standardized for comparability, how to
calculate the Medicare contribution, the role FFS, and the structure of subsidies for low-income
beneficiaries.
Reducing Medicare payment differences across sites of care. Medicare’s payment rates often
vary for similar services provided to similar patients, simply because they are provided in different sites of
care. For example, Medicare pays 141 percent more for one type of echocardiogram when done in a
hospital outpatient department than when it is done in a freestanding physician’s office. If Medicare pays a
higher rate for a service in one setting over another, program spending increases and beneficiaries pay
more in cost sharing without a corresponding increase in quality of care.
The Commission previously recommended reducing the rate Medicare pays for basic office visits from the
payment rate in the outpatient setting to the physician office rate. Using similar criteria, this report identifies
additional services that may be eligible for equalizing or narrowing payment differences across settings.
Bundling post-acute care services. Each year, about one-quarter of Medicare beneficiaries receive
care following a hospitalization from a post-acute care provider, such as a skilled nursing facility, home
health agency, or inpatient rehabilitation facility. However, nationwide the use of these services varies
widely, for reasons not explained by differences in beneficiaries’ health status. Under traditional
Medicare, the program pays widely varying rates for different settings and—characteristic of FFS—pays
based on the volume of care provided, without regard to quality or resource use.
Medicare has begun to explore the possibility of bundling services as a way to encourage providers to
coordinate and furnish needed care more efficiently. In this report, the Commission explores the
implications for quality and program spending for different design features of the bundles, such as the
services included, the length of time covered by the bundle, and the method of payment.
Reducing hospital readmissions. In 2008, the Commission recommended a hospital readmissions
reduction program to improve patient experience and reduce Medicare spending. In 2012, Medicare
began such a program, penalizing hospitals that have high rates of Medicare beneficiaries being
readmitted to the hospital within 30 days of discharge. The readmission penalty has given hospitals a
strong incentive to improve care coordination across providers, and for that reason Medicare should
continue to implement the policy. In this report, the Commission suggests further refinements to
improve incentives for hospitals and generate program savings through reduced readmissions rather than
higher penalties.
Payments for hospice services. The Medicare hospice benefit provides beneficiaries an important
option for end-of-life care. At the same time, the Commission has identified several problems in the way
Medicare pays for hospices that may lead to inappropriate use of the benefit. The report presents
information on the prevalence of long-stay patients and the use of hospice services among nursing home
patients—both of which may inform policy development in the hospice payment system in the future. It
also presents further evidence to support the Commission’s March 2009 recommendations to revise the
hospice payment system.
Improving care for dual-eligible beneficiaries. Beneficiaries eligible for both Medicare and
Medicaid—many of whom have complex medical and social needs—often have trouble accessing
services and receive little care coordination, resulting in poorer health outcomes and higher spending
relative to other beneficiaries. Programs that coordinate dual-eligible beneficiaries’ Medicare and
Medicaid benefits have the potential to improve care for this population. In the report, the Commission
notes that federally qualified health centers and community health centers may be uniquely positioned to
coordinate care for dual-eligible beneficiaries because they provide primary care, behavioral health
services, and care management services, often at the same clinic site.
Mandated reports. The report includes three chapters that fulfill Congressional mandates: one on
Medicare ambulance add-on payments, a second on geographic adjustment of fee schedule payments for
the work effort of physicians and other health professionals, and a third on Medicare payment for
outpatient therapy services. In each case, the Commission considers the existing policies—which are not
permanent statutory provisions—and examines the effect of their continuation or termination on
program spending, beneficiaries’ access to care, and the quality of care beneficiaries receive, as well as
their potential to advance payment reform.
The three congressionally mandated reports are described in further detail in separate fact sheets, posted
on MedPAC’s website. The full report can be downloaded from MedPAC’s website:
http://medpac.gov/documents/Jun13_EntireReport.pdf
Read more about Medicare and Workers' Compensation
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Saturday, September 6, 2014
NH Governor Hassan Creates Workers’ Compensation Commission for Reform
“Employers and workers have done their part to increase workplace safety, but New Hampshire has become one of the most expensive states in the nation for workers’ compensation, a burden on businesses across the state,” Governor Hassan said. “By bringing together business leaders and experts from insurance, health care and labor, the Commission to Recommend Reforms to Reduce Workers’ Compensation Medical Costs provides an opportunity for stakeholders to identify ways to reduce workers’ compensation medical costs and ensure that injured workers have access to quality care. With these reforms, our businesses will be able to re-invest these dollars in growing their companies, creating new jobs and keeping our economy moving in the right direction.”
Tasked with making recommendations to reform New Hampshire’s workers’ compensation system, the commission will review the data behind New Hampshire’s high workers’ compensation costs; analyze efforts by other states to successfully reduce workers’ compensation costs; review how other states ensure continued access to quality care for injured workers; and develop comprehensive reforms that will reduce costs and premiums and improve New Hampshire’s workers’ compensation system while ensuring that injured workers have access to quality care.
According to the Oregon Workers Compensation Rate Ranking Study, New Hampshire rose from the 14th-most expensive state for workers’ compensation coverage in the country in 2008 to the ninth-most expensive in 2012. In addition, data from the National Council on Compensation Insurance shows that workers’ compensation surgical procedures in New Hampshire are 83 percent more expensive than those in the region and more than twice as expensive as they are nationally. For more information on New Hampshire’s workers’ compensation costs, visit www.nh.gov/insurance/media/pr/2014/documents/052214.pdf .
“New Hampshire is among the most expensive states for workers’ compensation, an unnecessary disadvantage for businesses that operate here,” said New Hampshire Insurance Department Commissioner Roger Sevigny. “I look forward to working with the commission to improve our workers’ compensation system by making recommendations to reduce costs and premiums while ensuring that workers have access to quality care.”
Commissioner Sevigny will be the chairman of the Commission to Recommend Reforms to Reduce Workers’ Compensation Medical Costs. He will be joined on the commission by New Hampshire Department of Labor Commissioner Jim Craig or a designee from the department, as well as a diverse group of experts representing workers, employers, insurance professionals and the health care sector.
The Commission’s final report is due to the Governor on December 1, 2014.
Other members of the commission are:
Brian Allen, Vice President of Government Affairs at HELIOS (formerly Progressive Medical/PMSI)
Donald F. Baldini, AVP and State Affairs Officer at Liberty Mutual Insurance
Pamela Bronson, Administrator at Access Sports Medicine & Orthopedics
Paul W. Chant of Cooper Cargill Chant
Tammy Denver, Director of Claims & Coverage Programs at NH Public Risk Management Exchange (Primex3)
Edward Dudley, Executive Vice President/CFO of Catholic Medical Center
Mark Erdody, Director of New England Claims for Cove Risk Services, LLC
Marc Lacroix, New Hampshire Physical Therapy Association and Director of Specialty Services at Concord Hospital
David Lang, President of Professional Firefighters of NH
Mark Mackenzie, President of NH AFL-CIO
Peter McNamara, President of NH Automobile Dealers Association
Dr. Gregory Soghikian of New Hampshire Orthopaedic Center
Ben Wilcox, President & General Manager of Cranmore Mountain Resort
Full text of the Governor’s Executive Order
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Wednesday, January 22, 2020
NJ Benefits to Increase for Certain Injuries and a Study Commission Will Review System Going Forward
Wednesday, October 29, 2014
New Testing Reveals Hidden Dangerous Chemicals in Popular Halloween Costumes and "Trick or Treat" Bags
Study Finds Costumes and Party Supplies Sold by Top Retailers Contain Hazardous Additives
- Thirty-three of the 106 tested Halloween products contained polyvinyl chloride (vinyl or PVC) components.
- Seventeen of the vinyl products were tested for phthalate plasticizers. Of these, two items contained phthalates that were recently banned by the Consumer Product Safety Commission in children's products. One of these was a Toddler Batman Muscle Costume purchased at Walmart. In the costume's yellow belt, HealthyStuff.org measured 29% regulated phthalates (290,000 ppm) and 340 ppm tin. Lead was detected in the mask inner lining at 120 ppm. Overall, five percent of all products were measured to have lead exceeding 100 ppm.
- The study also documented an ongoing shift away from phthalate plasticizers in flexible vinyl products. Tests showed that fifteen of the vinyl items tested were plasticized with the less toxic chemical DOTP.
- Ten percent of the products contained levels of bromine consistent with brominated flame retardants. Two Disney-themed Trick-or-Treat bags purchased at Kroger, for example, contained 28,000 ppm and 6,000 ppm bromine, respectively. Halloween light sets purchased at Walgreen's and CVS contained similarly high amounts of bromine.
- Many of the products with brominated flame retardants also contained high levels of antimony, suggesting an antimony-based flame retardant was used in addition to the brominated chemicals.
- Thirty-nine percent of the vinyl products, ranging from dress-up shoes to a skeleton "light stick," contained tin at levels suggesting organotin stabilizers. Vinyl products were twice as likely to contain tin as non-vinyl materials. Some forms of organotins are endocrine disruptors; other forms can impact the developing brain and damage the immune system.
- Contact your favorite retailer and ask them to sell non-toxic supplies.
- Avoid vinyl products: select cloth and natural materials for costumes and decorations.
- Make up and masks: Use paint and pencils made from clay or other natural ingredients, or make your own.
- Trick or Treating: use old pillowcases or reusable shopping bags
- Pumpkins: Roast and eat the seeds and compost the pumpkin when you're done.
- Decorations: Avoid plastics and instead use paper, cardboard, leaves or other natural and recyclable materials for your decorations.
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Tuesday, June 23, 2015
Workers' Exposure to Low Dose Radiation Linked to Leukemia and Lymphoma
A study published in The Lancet reports strong evidence of positive associations between protracted low-dose radiation exposure and leukemia.
Evidence before this study:
Ionising radiation causes leukaemia. The primary quantitative basis for radiation protection standards comes from studies of populations exposed to acute, high doses of ionising radiation. Although previous studies of nuclear workers addressed leukaemia radiogenicity, questions remain about the size of the risk from protracted radiation exposure in occupational settings.
Added value of this study:
We report a positive dose–response relationship between cumulative, external, protracted, low-dose exposure to ionising radiation, and subsequent death caused by leukeamia (excluding chronic lymphocytic leukaemia). The risk coefficient per unit dose was consistent with those derived from analyses of other populations exposed to higher radiation doses and dose rates.
Implications of all the available evidence:
The present study provides strong evidence of a positive association between radiation exposure and leukaemia even for low-dose exposure. This finding shows the importance of adherence to the basic principles of radiation protection—to optimise protection to reduce exposures as much as reasonably achievable and—in the case of patient exposure—to justify that the exposure does more good than harm.
Wednesday, September 4, 2013
UConn Health Center Study: Conn. Occupational Illnesses Above National Average
There were 7,265 unique cases of occupational illnesses reported to either the Workers’ Compensation Commission or the Department of Public Health in 2011 based on a study by the UConn Health Center prepared for the Connecticut Workers’ Compensation Commission. This is in addition to cases of traumatic occupational injury reported by the Connecticut Labor Department in its annual survey. The overall 2011 rate of occupational illness in Connecticut is 27.8 illnesses per 10,000 workers, 35 percent higher than the national average, based on the standardized survey compiled by the Connecticut Labor Department. Both numbers of illnesses and rates of illnesses increased over 2010 for all three data sources for the report, although one of those sources was incomplete for the earlier year. Occupational Disease in Connecticut, prepared for the Connecticut Workers’ Compensation Commission by occupational and environmental expert Tim Morse of the Health Center, reviewed information for the 2011 reporting year from three sources: the State Labor Department/Bureau of Labor Statistics (BLS) survey; the Reports of First Injury to the Connecticut Workers Compensation Commission; and the physicians reports to the Connecticut Department of Public Health under the Occupational Illnesses... |
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Wednesday, February 2, 2011
California Report Makes Recommendations To Curtail Lien Claimants
The California workers compensation court has become a collection agency for unpaid bills. This issue is mirrored throughout the US as medical costs have soared and a single payer system has not yet been enacted as in European countries.
The study commission concluded that the volume of liens alone amounts to "coercion to settle." The report reveals that 35% of the present court calendar now involves liens. The cost to employers amounts to an estimated $200 Million annually. Over 450,000 liens are predicted to be filed this yea alone. Medical liens represent the vast majority of the liens filed in compensation cases.
Excluded from consideration in he report are Federal medical programs such a Medicare (Medicare Secondary Benefit claims), VA Medical claims and TRICARE (Military Health Plans.). Those claims can only be resolved only by a tribunal cloaked with Federal jurisdiction.
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Saturday, February 28, 2015
Study Urges Greater Financial Disclosure by Nonprofit Integrated Health Systems
Along with a comprehensive review of the academic literature, the study included an analysis of publicly available quality and financial information from 15 of the largest nonprofit integrated delivery networks (IDNs) across the country, including Henry Ford Health System in Detroit; North Shore-LIJ Health System in suburban New York; Intermountain Healthcare in Utah/Idaho; Sutter Health in Northern California; BayCare Health System in Tampa/St. Petersburg; and Geisinger Health System in Central Pennsylvania.
The study defined IDNs as vertically integrated health services networks that include hospitals, physicians, post-acute services and sometimes health plans with a stated purpose to coordinate care across the continuum of health services and to manage population health; or fully integrated provider systems inside a health plan (e.g. with no other source of income than premiums).
"Some of the nation’s finest hospitals and clinical staffs can...
[Click here to see the rest of this post]
Monday, February 7, 2022
Order: Workers' Compensation Law 2022 Update
Jon Gelman’s* newly revised and updated treatise on Workers’ Compensation Law can now be ordered from Thomson Reuters®. The treatise is the most complete and research integrated work available on NJ Workers’ Compensation law.
Friday, February 12, 2021
Just Published - Workers' Compensation Law 2021 COVID-19 Update
Jon Gelman’s* newly revised and the updated treatise on Workers’ Compensation Law has been published by Thomson Reuters®. The treatise is the most complete and research integrated work available on NJ Workers’ Compensation law. Updated annually for over 35 years, this body of work provides practical tips, objective analysis, and academic support for the workers' compensation community.
Thursday, August 23, 2007
Drop in California Spending Lowers U.S. Workers' Compensation Benefits and Costs
WASHINGTON, DC—U.S. workers’ compensation payments for medical care and cash benefits for workers disabled by workplace injuries or diseases declined in 2005, according to a study released today by the National Academy of Social Insurance (NASI).
The drop in payments in 2005 (the most recent year with data) reflects large declines in California payments, as reforms enacted in 2003 and 2004 took effect. Nationally, workers’ compensation payments for injured workers fell by 1.4 percent to $55.3 billion in 2005. The payments include $26.2 billion to providers of medical care and $29.1 billion in cash wage replacement benefits for injured workers. California payments fell by 12.2 percent; a change made up of a 16.0 percent decline in medical payments and an 8.6 percent decline in cash payments. “The reduced spending for benefits and medical care reflects the initial stages of cost containment measures that were put in place in 2003 and 2004 reforms to the California system,” according to NASI member Christine Baker, who directs the California Commission on Health and Safety and Workers’ Compensation, a nonpartisan labor-management group that advises state policymakers.
Because it is a large state – accounting for nearly 20 percent of national benefit payments in 2005 –California altered national trends. Outside California, total workers’ compensation payments rose by 1.7 percent, an increase driven by a 4.1 percent increase in payments to medical providers. Cash payments to injured workers outside California showed a small decline (0.3 percent).
The costs to employers for workers’ compensation are what they pay each year. For employers who buy insurance, costs are premiums they pay to insurance companies plus benefits they pay under deductible arrangements in their insurance policies. For employers who insure their own workers, costs are the benefits they pay plus administrative costs. In 2005, employers paid a total of $88.8 billion nationwide for workers’ compensation. A sharp drop in California employers’ costs (of 9.8 percent) held down the national increase in employer costs to 2.3 percent. Outside California, employer costs for workers’ compensation rose by 6.5 percent.
The new report tracks trends since 1989 in workers’ compensation benefits and employer costs relative to total wages of workers covered by the program. Relative to wages, cash benefits in 2005 were the lowest in 17 years ($0.56 per $100 of wages). Nationally, total benefits (cash plus medical) and employer costs fell relative to wages in 2005. Cash and medical benefits combined were $1.06 per $100 of covered wages in 2005, a drop of $0.07 from 2004, while employer costs were $1.70 per $100 of wages in 2005, down $0.05 from 2004.
Outside California, benefits per $100 of wages fell by a smaller amount ($0.03) and employer costs per $100 of wages rose slightly (by $0.02). According to John F. Burton, Jr., chair of the panel that oversees the study, “The relative stability of benefits outside the Golden State reflects a rough balance between the declining frequency of workplace injuries and higher expenditures for medical benefits.”
The new report, Workers’ Compensation: Benefits, Coverage and Costs, 2005, is the tenth in a NASI series that provides the only comprehensive national data that covers all types of employers. The study provides estimates of workers’ compensation cash and medical payments for each state, the District of Colombia, and federal programs.
To download the full report, click here.
To download a PDF of this release, click here.
Thursday, December 2, 2010
Congressional Deficit Reform May Incorporate Workers Compensation Awards
- Congress Told Workers Compensation is a Deteriorating System (workers-compensation.blogspot.com)
- Congresswoman Woolsey Calls For A GAO Study of Workers Compensation-Cites Insurance Company Cost Shifting (workers-compensation.blogspot.com)
- USPS May Declare Bankruptcy Citing High Workers Compensation Costs (workers-compensation.blogspot.com)
- Employee Sues Co-Worker Following Perfume Assault (workers-compensation.blogspot.com)
Tuesday, November 29, 2011
Changing the Fundamental Rules of Workers Compensation
Read the article, "Workers 'should not be able to sue for accidents if it's their fault' (dailymail.co.uk)
"In a review published next week there are calls for a 'rebalancing' of safety laws and a dramatic reduction in the number of rules in the workplace......" read more
......
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Tuesday, February 7, 2023
Available Workers' Compensation Law 2023 Update
Jon Gelman’s* newly revised and updated treatise on Workers’ Compensation Law is now available from Thomson Reuters®. The treatise is the most complete and research-integrated work on NJ Workers’ Compensation law.
Friday, November 2, 2018
The Evidence Mounts on the Causal Link of Cell Phones and Cancer
Thursday, August 9, 2012
Cell Phone and Brain Malignancies: The Right to Know Radiation Act
(Photo credit: Wikipedia) |
Congressman Dennis Kucinich (D-OH) has introduced H.R. 6358, the Cell Phone Right to Know Act, a bill to grant a consumer’s right-to-know by providing for warning labels on cell phones. It would also create a new national research program to study cell phones and health and require the Environmental Protection Agency to update the outdated Specific Absorption Rate (SAR). A federal appeals court in San Francisco is expected to consider a local right-to-know ordinance this week.
“Consumers have a right to know the radiation levels of cell phones and whether they are buying the phone with the lowest – or the highest – level of exposure to cell phone radiation. They also deserve to have up-to-date exposure standards that are put together by health professionals without conflicts of interest,” said Kucinich.
When Kucinich first called a hearing on the issue as Chair of the Domestic Policy Subcommittee on September 25, 2008, Dr. Ronald Herberman, then Director of the University of Pittsburgh Cancer Institute, testified to the Subcommittee, “I cannot tell this committee that cell phones are dangerous, but I certainly can't tell you they are safe.”
Last year, the World Health Organization finished its assessment of the evidence about the links between exposure to radiation from cell phones and health problems. They concluded that there was enough evidence of a link to classify it as “possibly carcinogenic to humans,” placing it in the same category as lead and mercury.
The long-awaited Interphone study, a major inquiry into the potential links between cell phone use and tumors, concluded that when taken as a whole, there was not a link. However, when the data was broken down, more risk was found and the picture became clearer. Those using their cell phones typically only 30 minutes per day or more were found to have a 40% increased risk of a type of brain tumor called glioma, when compared to someone who had not used a cell phone. If the phone is used mostly on one side of the head, the risk is 96% more than someone unexposed to cell phone radiation.
“It took decades for scientists to be able to say for sure that smoking caused cancer. During those decades, the false impression created by industry supporters was that there was no connection between smoking and cancer, a deception which cost many lives. While we wait for scientists to sort out the health effects of cell phone radiation, we must allow consumers to have enough information to choose a phone with less radiation,” said Kucinich. “As long as cell phone users may be at increased risk of cancer or reproductive problems, Americans must have the right to know the radiation levels of cell phones.”
The warning labels required by H.R. 6358 would show the RF radiation emissions from the phone, legal limits and health-based goals for safe exposure. According to the Federal Communications Commission (FCC) the SAR is “the amount of radio frequency energy absorbed by the body when using a mobile phone.” The current SAR sets a maximum level of radiation emission at 1.6 watts per kilogram. The current SAR does not take into account vulnerable populations like kids or pregnant women. It also assumes a person’s only exposure is from the phone in use, but with WiFi, “smart phones,” and Bluetooth technologies, exposure to only one wireless device is increasingly rare, especially in urban environments. A Government Accountability Office report on cell phones and health is expected to be released soon.
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Monday, November 22, 2010
Congress Told Workers Compensation is a Deteriorating System
As Professor points out, the aging workforce further complicates the burden placed upon the nation's Medicare system. With the erosion of the doctrine that workers' compensation takes the worker as it finds him or her, medical treatment for pre-existing conditions will be a growing cost for Medicare and a cost-shift from the workers' compensation system. The NY Times reported that, "Nearly one-fourth of Medicare beneficiaries have five or more chronic conditions. They account for two-thirds of the program’s spending."
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- USPS May Declare Bankruptcy Citing High Workers Compensation Costs (workers-compensation.blogspot.com)
- Dean Emily Spieler Requests Congress to Review The Workers' Compensation Disability Rating System (workers-compensation.blogspot.com)
- Congress to Hear Experts on New State Workers' Compensation Limitations (workers-compensation.blogspot.com)