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Taransky v. Sebelius, Civil Action No. 12-4437, 2013 WL 3892360 (D. NJ 2013) June 13, 2013
Wednesday, July 31, 2013
Liability Claim Collateral Source Payments Subject to MSP
Medicare is not required to abide by a stipulated order of allocation of benefits in a liability case when seeking reimbursement under the Medicare Secondary Payer Act (MSP). Also, the New Jersey Collateral Source Statute (“NJCSS”)did not apply to MSP reimbursement claims and collateral proceeds were reimbursable.
" For the reasons described above, the Court concludes that it lacks subject matter jurisdiction over Ms. Taransky's “due process” and “proportionality” claims, as Ms. Taransky failed to administratively exhaust these claims. Additionally, the Court concludes that there is substantial evidence in the record supporting the MAC's properly-reasoned conclusion that in obtaining a tort settlement in a trip-and-fall accident, and notwithstanding a state trial court's order allocating this tort settlement recovery to non-medical expenses, Ms. Taransky received payment from a “primary plan” responsible for payment of her medical expenses that had been covered by Medicare. As a result, Ms. Taransky is required to reimburse Medicare $10,121.15 pursuant to the MSP."
Taransky v. Sebelius, Civil Action No. 12-4437, 2013 WL 3892360 (D. NJ 2013) June 13, 2013
Taransky v. Sebelius, Civil Action No. 12-4437, 2013 WL 3892360 (D. NJ 2013) June 13, 2013
Tuesday, July 30, 2013
WellPoint Sees Small Employers Dropping Health Coverage
Complicating the health insurance scene is the fact that injured workers who been denied workers' compensation benefits might have no safety net under Obamacare. As the system rolls out, in those situations, the states with slow disposition rates of workers' compensation claims will become fertile jurisdictions for workers' compensation reform to remedy this injustice. Today's post was shared by Kaiser Health News and comes from capsules.kaiserhealthnews.org
1.
As the nation prepares to roll out the next phase of Obamacare, the second biggest medical insurer said Wednesday that it expects to lose members in health insurance plans sponsored by smaller employers.
“I would not call it an academic assumption at this point,” WellPoint chief financial officer Wayne DeVeydt said on a conference call with stock analysts. “We continue to see small group attrition accelerate even more as we get to the back half of the second quarter. And we expect that to continue.”
The lost customers aren’t just signing up with WellPoint rivals, according to DeVeydt. “Some of it is going into the uninsured ranks,” he said. At the same time, WellPoint expects membership gains in self-insured employer plans and in the kind of individual plans that will be sold in subsidized exchanges starting Oct.
The Obama administration recently postponed enforcement of a requirement that employers with 50 employees or more offer health coverage next year or face fines. But the delay in the “employer mandate” wasn’t the reason WellPoint gave for losing small-group members. Nor did executives respond directly to analyst’s questions about whether small employers are “dumping” workers into the subsidized individual market.
Rather, small employers have hesitated to buy coverage for next year because of uncertainties surrounding the online exchanges offering individual and small-group plans, the...
“I would not call it an academic assumption at this point,” WellPoint chief financial officer Wayne DeVeydt said on a conference call with stock analysts. “We continue to see small group attrition accelerate even more as we get to the back half of the second quarter. And we expect that to continue.”
The lost customers aren’t just signing up with WellPoint rivals, according to DeVeydt. “Some of it is going into the uninsured ranks,” he said. At the same time, WellPoint expects membership gains in self-insured employer plans and in the kind of individual plans that will be sold in subsidized exchanges starting Oct.
The Obama administration recently postponed enforcement of a requirement that employers with 50 employees or more offer health coverage next year or face fines. But the delay in the “employer mandate” wasn’t the reason WellPoint gave for losing small-group members. Nor did executives respond directly to analyst’s questions about whether small employers are “dumping” workers into the subsidized individual market.
Rather, small employers have hesitated to buy coverage for next year because of uncertainties surrounding the online exchanges offering individual and small-group plans, the...
Protective Equipment for Workers in Hurricane Flood Response
Over the last few years workers in the US have learned that Hurricanes and Super Storms create serious occupational hazards. THE CDC (Centers for Disease Control) has published preparation guidelines so that employees can be adequately protected for these serious and deadly weather related events. Today's post was shared by Safe Healthy Workers and comes from the US CDC.
STORM, FLOOD, AND HURRICANE RESPONSE
Hazard Based Guidelines: Protective Equipment for Workers in Hurricane Flood Response
On this Page
The purpose of this National Institute for Occupational Safety and Health (NIOSH) fact sheet is to provide general guidance for personal protective equipment (PPE) for workers responding in hurricane flood zones. This guidance will be updated as additional information is available. PPE selection and use is site and task specific. General guidelines must be adapted to specific conditions. This guidance represents professional judgment based on experience from responses to past storms and floods. Additional interim recommendations will be added for clean-up and restoration operations.
These recommendations focus on the following hazards associated with response activities:
Hazard 1 Sharp jagged debris
Hazard 2 Floodwater exposure
Hazard 3 Electrical hazards
Hazard 4 Contact with blood/body fluids and handling animal and human remains
Hazard 5 Slick and unstable surfaces
Note: This guidance is not a comprehensive list of hazards and does not include important hazards such as stress or fatigue that are not addressed via PPE.
...
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Society for Chemical Hazard Communication
Employers now have access to additional resource so that they can comply with the OSHA revised Hazard Communication Standard. This post was shared by US Dept. of Labor and comes from
03/01/13
Hazard Communication resources available to help employers comply with new training and labeling requirements
Two new compliance assistance resources are available for employers to assist them in meeting the requirements of OSHA's revised Hazard Communication Standard. A new fact sheet (PDF*) discusses the training topics that employers must cover for the initial Dec. 1, 2013 deadline. By this date, employers must train workers on the new label elements and safety data sheet format. In addition, a new OSHA brief (PDF*) explains the new labeling elements, identifies what goes on a label, and describes what pictograms are and how to use them. The brief also provides manufacturers, importers, distributors and other employers with a step-by-step guide to create a label that meets the requirements of the revised standard. The deadline for adopting the new labels and pictograms is June 1, 2015.
OSHA's updated standard, which is aligned with the United Nations' Globally Harmonized System of Classification and Labeling of Chemicals, provides a common and coherent approach to classifying chemicals and communicating hazard information on labels and safety data sheets. The revised standard is improving the quality and consistency of hazard information in the workplace, making it safer for workers by providing easily understandable information on appropriate handling and safe use of hazardous chemicals. Additional information and resources are available on OSHA's Hazard...
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Monday, July 29, 2013
Get the Download on Ladder Safety
Today's post was shared by US Dept. of Labor and comes from The Labor Department’s Occupational Safety and Health Administration is learning how international collaboration and mobile technology can make for a fresh approach to educating employers and vulnerable workers about workplace safety.
Last year, OSHA Director of Construction Jim Maddux delivered a presentation on OSHA’s new campaign to prevent fatal falls at the annual conference of the American Society of Safety Engineers. When he finished, one of the conference leaders rushed over, eager to introduce Maddux to representatives from another agency with a similar mission of stopping falls in construction:
Singapore’s Ministry of Manpower.
Falls are the No. 1 killer in construction in the United States and are a problem in the construction industry worldwide. The Singapore group showed Maddux a number of outreach publications they used to educate workers, employers, supervisors and foremen about how to work safely from heights, including a short English- and Chinese-language pamphlet on ladder safety.
Singapore’s Ministry of Manpower.
Falls are the No. 1 killer in construction in the United States and are a problem in the construction industry worldwide. The Singapore group showed Maddux a number of outreach publications they used to educate workers, employers, supervisors and foremen about how to work safely from heights, including a short English- and Chinese-language pamphlet on ladder safety.
Caregivers for Cancer Patients and Survivors
Over the years I have come to realize that support for both cancer patients and their caregivers is very important. The disease affects not only the patient but the patient's entire constellation of family and friends. Today's post was shared by CDC Cancer and comes from
Caregiving Resources
Find a nursing home, assisted living, or hospice; check your eligibility for benefits; get resources for long-distance caregiving; review legal issues; and find support for caregivers using this comprehensive list from USA.gov.
General Information About Caregivers and Caregiving
- Framing the Public Health of Caregiving (American Journal of Public Health)
- Family Caregivers in Cancer (National Cancer Institute)
- Who Is a Caregiver? (National Cancer Institute)
- Coping with Cancer: For Caregivers, Family, and Friends (National Cancer Institute)
- Caregivers (Medline Plus)
- Caregiving: A Public Health Priority (CDC)
- Caregivers (American Cancer Society)
- Caregivers as Partners and Clients of Behavioral Health Services [PDF-578KB] (Administration on Aging)
Agencies and Organizations
- National Family Caregiver Support Program (Administration on Aging)
- Support for Caregivers (Medicare)
- Caregiver Action Network
- Family Caregiver Alliance
- National Alliance for Caregiving
Helpful Resources for Caregivers
CDC
...
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.
US Asbestos Consumption Only Slightly Down in 2012
The US Geological survey reported today, that asbestos, still NOT yet banned in the US, is still being consumed domestically at incredible rates. Asbestos is a known carcinogen, causing mesothelioma, a rare and fatal disease.
"Asbestos has not been mined in the United States since 2002
with imports meeting the needs of the domestic marketplace.
Estimated U.S. apparent consumption was 1,020 metric tons (t)
in 2012, a 14% decrease from 1,180 t in 2011. World production
was 1.97 million metric tons (Mt) in 2012, a slight decrease
from 2.02 Mt in 2011.
"Consumption
In 2012, U.S. apparent consumption of asbestos decreased
by 14% from that in 2011 (table 1). The chloralkali industry
was the leading consumer of asbestos with an estimated 67%
of the market; followed by roofing products, 30%; coatings and
compounds, plastics, and other, 3%. The chloralkali industry
increased its share of the overall asbestos sales owing mainly to
the decreased use of asbestos in roof coating formulations. Only
a few U.S. companies manufacture asbestos-based products.
"Asbestos has not been mined in the United States since 2002
with imports meeting the needs of the domestic marketplace.
Estimated U.S. apparent consumption was 1,020 metric tons (t)
in 2012, a 14% decrease from 1,180 t in 2011. World production
was 1.97 million metric tons (Mt) in 2012, a slight decrease
from 2.02 Mt in 2011.
"Consumption
In 2012, U.S. apparent consumption of asbestos decreased
by 14% from that in 2011 (table 1). The chloralkali industry
was the leading consumer of asbestos with an estimated 67%
of the market; followed by roofing products, 30%; coatings and
compounds, plastics, and other, 3%. The chloralkali industry
increased its share of the overall asbestos sales owing mainly to
the decreased use of asbestos in roof coating formulations. Only
a few U.S. companies manufacture asbestos-based products.
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