Copyright

(c) 2010-2024 Jon L Gelman, All Rights Reserved.
Showing posts sorted by date for query designing. Sort by relevance Show all posts
Showing posts sorted by date for query designing. Sort by relevance Show all posts

Thursday, June 23, 2022

"Unmasking COVID" in 2022, Where Are We Now?

A panel of infectious disease experts and public health specialists of the Veterans Administration who have been involved in the national COVID response discuss strategies to contain the spread of the Omicron variant and stay safe.

Friday, July 14, 2017

The Rise and Fall of Workers' Compensation - The Path to Federalization

Every year The Board of Trustees of the Federal Hospital Insurance and Federal Supplemental Medical Supplemental Medical Insurance Trust Funds makes an actuarial guess as to the future financial solvency of Medicare. The report creates an annual news frenzy in the workers’ compensation community since Medicare is both the safety net for injured workers and playground for employers and their insurance companies to use in cost shifting,

Friday, October 7, 2016

US Department of Labor Urges Major Changes in the Nation's Workers' Compensation System

As The Path to Federalization of the US workers' compensation system broadens, the US Department of Labor has published a report urging expansion of the Federal role in reforming the entire patchwork of state systems. As the Presidential Election Cycle moves ahead, the ultimate outcome will impact the the nation's struggling workers' compensation scheme. Based on historical statements both "Hillarycare" or "Trump Medical," (lead by his advisor, Former Speaker Newt Gingrich,  will focus on this issue. See  my prior blog posts below.

Monday, January 18, 2016

Sanders Proposes Universal Health Care: The Path to Federalization


Presidential candidate Bernie Sanders has announced a plan to move forward with a Universal Medical Care program in the US. The concept will absorb the nation's ailing the medical workers' compensation delivery system into a universal care system.

Thursday, June 25, 2015

The Path to Federalization: US Supreme Court Again Validates the Affordable Care Act

The US Supreme Court again affirmed the validity of The Affordable Care Act. The Obamacare program, as it has been nicknamed, will continue to lead to a medical delivery program than eventually will have major repercussions on the antiquated and ineffective medical care system of the existing patch work of state workers' compensation insurance acts.

Sunday, May 3, 2015

Synchromed II Implantable Infusion Pump Systems: FDA Consent Decree To Limit Use

Medtronic, Inc. cited for manufacturing violations

The U.S. Food and Drug Administration announced today the filing of a consent decree against Medtronic, Inc., and two of the company’s officers—S. Omar Ishrak and Thomas M. Tefft —for repeatedly failing to correct violations, related to the manufacture of Synchromed II Implantable Infusion Pump Systems, medical devices that deliver medication to treat primary or metastatic cancer, chronic pain and severe spasticity. These violations occurred at the company’s Neuromodulation facilities in Columbia Heights, Minnesota, where the devices are manufacture.

The consent decree cites violations of the quality system regulation for medical devices, which requires manufacturers to have processes in place to assure that the design, manufacture and distribution of a device allows for its safe us

The legal action requires the company to stop manufacturing, designing and distributing new Synchromed II Implantable Infusion Pump Systems except in very limited cases, such as when a physician determines that the Synchromed II Implantable Infusion Pump System is medically necessary for a patient’s treatment.

The consent decree also requires Medtronic to retain a third-party expert to help develop and submit plans to the FDA to correct violations. The consent decree will remain in effect until the FDA has determined that Medtronic has met all the provisions listed in the consent decree.

Once Medtronic receives permission from the FDA to resume the design, manufacture and distribution of these products, the company must continue to submit audit reports so the agency can verify the company’s compliance. In addition to these audits, the FDA will monitor the company’s activities through its own inspections.

The FDA first approved the Synchromed II Implantable Infusion Pump Systems in 2004, and first identified problems with the manufacture of these pumps in 2006. These problems can result in over- or under-infusion or a delay in therapy for patients.

Between 2006 and 2013, FDA investigators conducted five inspections at Medtronic’s Neuromodulation facilities, resulting in three warning letters notifying the company of major violations. The violations included inadequate processes for identifying, investigating, and correcting quality problems with the Synchromed II Implantable Infusion Pump Systems; failure to document design changes; and failure to ensure that finished products meet design specifications.

“The FDA expects that all patients will be treated with safe, effective and high-quality medical devices,” said Jan Welch, acting director of the Office of Compliance in the FDA’s Center for Devices and Radiological Health. “We will continue to stop distribution of devices made by firms that fall short of regulatory requirements.”

Patients who are implanted with a Synchromed II Implantable Infusion Pump System should maintain regular follow-up appointments with their physicians. Patients who experience a change or return of symptoms, or hear a device alarm, should contact their physician immediately.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety and effectiveness of human and veterinary drugs, biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.


Monday, August 18, 2014

Family of LAPD officer killed in Beverly Hills crash files lawsuit

Today's post was shared by The Workers' Injury Law & Advocacy Group and comes from www.latimes.com



The family of a 27-year LAPD officer has filed a wrongful death lawsuit against the cities of Los Angeles and Beverly Hills and the company that owns the truck that hit his vehicle and killed him.
Det. Ernest L. Allen Sr. was killed May 9 when an out-of-control concrete truck barreled downhill on Loma Vista Drive in Beverly Hills and slammed head-on into Allen’s pick-up truck, which was northbound on the winding, sloping road.

The collision marked the fourth major crash on the road in less than a year and the second one to kill a Los Angeles Police Department officer. On March 7, Officer Nicholas Lee was killed near the same stretch of Loma Vista by an out-of-control truck that was in the area for construction.
The May 9 collision is still under investigation, but Beverly Hills police investigators say it appears the truck’s brakes failed -- the same issue that appears to have been involved in Lee’s crash.

In the lawsuit filed Monday in Los Angeles County Superior Court, Allen’s mother and two children assign responsibility for his death to the truck’s driver for failing to maintain his vehicle; the company he worked for, Over & Over Ready Mix, for hiring him; and Beverly Hills and Los Angeles for designing the road and failing to keep it safe.
After Allen’s death, the city placed a 30-day...
[Click here to see the rest of this post]

Friday, May 30, 2014

Equal Work, Less-Equal Perks; Microsoft Leads the Way in Filling Jobs With 'Permatemps'

Today's post was shared by Steven Greenhouse and comes from www.nytimes.com

By STEVEN GREENHOUSE
Published: March 30, 1998
They hold high-prestige, high-technology jobs at Microsoft's plush campus. They often do the same work as the Microsoft Corporation's permanent employees, developing CD-ROM's, designing World Wide Web sites and writing software manuals. Yet they do not qualify for Microsoft's coveted stock options, and their health and vacation benefits are pale imitations of those enjoyed by regular Microsoft workers.
They are long-term temps -- a seeming oxymoron, but in fact a new and growing phenomenon in the American work force, embraced by many corporations, especially high-tech ones, including Microsoft, AT&T, Intel, Hewlett-Packard and Microsoft's Seattle neighbor, Boeing.
Microsoft is perhaps the leading practitioner of the trend, employing about 5,000 temps, including 1,500 long-term ones, meaning they have worked for the software colossus for at least one year. These temps work next to Microsoft's 17,000 domestic employees.
Some prefer the flexibility and the higher take-home pay that temp status affords, but many assail temping as a backdoor way to create a two-tier work force. The benefits that the lower tier loses out on, many temps say, far outweigh whatever extra pay they take home.
''It's a system of having two classes of people and instilling fear and inferiority and loathing,'' said Rebecca Hughes, who worked for three years as a temp at Microsoft, helping edit its CD-ROM on health care.
With work lives strung together by...
[Click here to see the rest of this post]

Tuesday, February 25, 2014

Throw The Book At 'Em

There seems to be no limit in the amount of fraudulent conduct that transpires within the workers' compensation system. If employer fraud is not enough, the system is constantly undergoing abuse from business interests, ie. medical provo\iders, who abuse the system. The Federal Governments role in enforcement is ever increasing and expansion is trending wider. The gobal expanssion nationally of a universal program for monitoring and enforcement of medical fraud is encouraging. Today's post is shared from David DePaolo http://daviddepaolo.blogspot.com/

It's a shame that hundreds, if not thousands, of injured workers underwent unnecessary spinal fusion surgeries and must live with the debilitating aftermath of significant disability because of people whose greed overrides the well being of fellow humans.

I had learned about Michael Drobot and Pacific Hospital of Long Beach, and their co-conspirators, preying on workers' compensation patients some time ago.

On Friday though, Federal prosecutors announced that Michael D. Drobot faces up to 10 years in prison after he pleaded guilty to paying kickbacks in a $500 million fraud scheme relating to spinal fusions and admitted to bribing state Sen. Ron Calderon to delay legislation to repeal the separate reimbursement for spinal hardware.

Calderon, D-Montebello, was indicted one day earlier on 24 charges, including bribery, money laundering, wire fraud and filing a false tax return. His brother, former...

[Click here to see the rest of this post]


Related articles

California state Sen. Ron Calderon accepted $88,000 in bribes, FBI affidavit alleges (workers-compensation.blogspot.com)
IMR: DWC Get Out of the Way (workers-compensation.blogspot.com)
One Claim Going OTOC (workers-compensation.blogspot.com)
Work Comp Lost Focus (workers-compensation.blogspot.com)
OK's True Cost Control Feature (workers-compensation.blogspot.com)
The Conflict Between NAFTA and Comp (workers-compensation.blogspot.com)
Being Professional (workers-compensation.blogspot.com)

Read more about "Federalization of Workers' Compensation"
Jul 05, 2012
United States Supreme Court has taken a giant leap forward to facilitate the Federalization of the entire nation's workers' compensation system. By it's recent decision, upholding the mandate for insurance care under the ...
Dec 23, 2010
Yesterday the US Congress passed and sent to the President, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program. The Federally ...
Jul 05, 2010
The trend toward Federalization of workers' compensation benefits took a giant step forward by recent Presidential action creating the British Petroleum Oil Compensation Fund. While the details remain vague, the broad and ...
Jun 14, 2012
Yesterday the US Congress passed and sent to the President, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program. The Federally .


Tuesday, December 10, 2013

Delay Or Deny At Your Risk

Today's post was shared by WorkCompCentral and comes from daviddepaolo.blogspot.com

There are so many reasons why both employers and workers feel that workers' compensation is "broken" or doesn't work.

Peter Rousmaniere, who is beginning work this week for WorkCompCentral, suggests in his column reviewing two studies on perceived delays in medical treatment that delay may arise as much from indifferent doctoring skills as days elapsing on the calendar.

An employer consultant relayed to me a factual scenario indicating another cause of this perception - standard claims administration protocol, which is defensive in nature as opposed to being aggressively pro-active.

Rousmaniere cites a couple of studies in his column. A Texas Department of Workers' Compensation survey of injured workers documents wide discrepancy in perceptions, but also notes that up to 50% of all survey respondents complained of some delay in receipt of treatment.

Another study cited by Rousmaniere conducted by Harbor Health, which specializes in designing workers’ compensation provider networks, looked for differences in claims outcome, including medical cost and litigation rates, and if surgical treatment happened early or late in the course of treatment.

Harbor Health found that early surgery in carpal tunnel cases (earlier than recommended by treatment guidelines) produced slightly more cost in medical expense but much less cost in indemnity expense.

Let's put these findings into context.

Assume a 28 year old male worker who complains of "...
[Click here to see the rest of this post]

Friday, May 17, 2013

Obamacare Will Be Collecting Workers' Compensation Medical Records

The implementation of Affordable Care Act data collection regulations will include the collection of medical information concerning work related accidents and injuries.  The coalition of this information will broadly advance the concept of universal medical care and impose yet another route for the Centers for Medicare and Medicare to strengthen enforcement under the Medicare Secondary Payer Act.

The largest and most expansive database of personalized medical information is being established under the umbrella of an newly created unit under the authority granted to the Internal Revenue Service, The Federal Data Services Hub. Personal medical records, including electronic medical records, will be incorporated into the program. 

"On March 23, 2010, the President signed into law the Patient Protection and Affordable Care Act 
(P.L. 111-148). On March 30, 2010, the Health Care and Education Reconciliation Act of 2010 
(P.L. 111-152) was signed into law. The two laws are collectively referred to as the Affordable 
Care Act. The Affordable Care Act creates new competitive private health insurance markets –
called Exchanges – that will give millions of Americans and small businesses access to 
affordable coverage and the same insurance choices members of Congress will have. Exchanges 
will help individuals and small employers shop for, select, and enroll in high quality, affordable 
private health plans that fit their needs at competitive prices. The IT systems will support a 
simple and seamless identification of people who qualify for coverage through the Exchange, tax 
credits, cost-sharing reductions, Medicaid, and CHIP programs. By providing a place for onestop shopping, Exchanges will make purchasing health insurance easier and more understandable 
and will put greater control and more choice in the hands of individuals and small businesses."

Read more about "Federalization" and workers' compensation:

Thursday, July 5, 2012

Path to Federalization: A National Workers Compensation System--US Supreme Court Validates

United States Supreme Court has taken a giant leap forward to facilitate the Federalization of the entire nation's workers' compensation system. By it's recent decision, upholding the mandate for insurance care under the Affordable Health Care for America Act (ACA) 2009, it has set the precedent to federalize the nation's fragmented and chaotic workers' compensation medical delivery system.

John G. Roberts Jr.,
Chief Justice US Supreme Court
Validating Mechanism
In a 5 to 4 ruling, Chief Justice Roberts validated the individual mandate as a permissible exercise of congressional power under the Taxing Clause of the US Constitution. Under 26 U.S.C. Section 5000A. The law requires that: (a) an individual must maintain minimum essential coverage for each month beginning after 2012; and (b) if there is a failure to maintain minimum essential coverage, a "penalty" is imposed "on the taxpayer" of $695 per year or 2.5% of family income, whichever is greater. The penalty "shall be assessed and collected in the same manner as taxes."

The Chief Justice, writing for himself, stated, "Every reasonable construction must be resorted to in order to save a statute from unconstitutionality." If it is "fairly possible" to interpret the statute as merely imposing a tax on those who've failed to purchase insurance. Writing for the majority, the Chief Justice stated, that the penalty is not a tax for anti-injunction act purposes. The Court, he wrote, needs to look beyond the label when assessing the constitutionality. For constitutional purposes Justice Roberts reasoned that the penalty may be considered as a tax when: it is not so high that there is no choice; and it is not limited to willful violations; and the penalty is collected by the IRS through normal means.

Constitution of the
United States
The Court indicated that the assessment is not really a "penalty." "Taxes that seek to influence conduct are nothing new," the Chief Justice wrote. He reasoned for the Court that there are no negative legal consequences to not buying health insurance, because beyond requiring a payment to IRS, Congress anticipated that some 4 million people would pay the penalty, and Congress did not treat them as "outlaws."

While certain taxes are prohibited under the U.S. Constitution, the penalty under the Affordable Health Care for America Act 2009 is not barred. The Court reasoned that the Constitution states, "No Capitation, or other direct, Tax shall be laid, unless in Proportion of the Census or Enumeration herein before directed to be taken." The majority of the Court held that a tax on "going without health insurance" does not fall within any recognized category of direct tax since it is triggered by certain specific circumstances.


The US Supreme Court previously validated compulsory workers' compensation programs. Compulsory compensation systems have been held not to be an arbitrary classification contrary to the equal protection clause of the United States Constitution, 14th Amendment.  The state-enacted systems were created for the protection of the lives, health and safety of the employees.  The systems provide payment of compensation through a state mandated system for injuries to employees or for the death of employees resulting from injuries related to work, regardless of fault.  The compensation systems are held as a simple, inexpensive and expeditious method of providing recovery to employees who are injured in a highly organized and modern industrial employment environment.  New York Central Railroad Company v. White, 243 U.S. 188, 37 S.Ct. 247, 61 L.Ed. 667 (1917). See also, Lower Vein Coal Co. v. Industrial Board of Indiana, 255 U.S. 144, 41 S.Ct. 252, 65 L.Ed. 555 (1921) and In re Asbestos Litigation, 829 F.2d 1233 (3d Cir.1987), cert. denied 485 U.S. 1029, 108 S.Ct. 1586, 99 L.Ed.2d 901 (1988).

Medical Delivery & Fees
Generally, the ACA provides a much needed national structure for the regulation, delivery, and enforcement of medical coverage. The ACA contains significant fraud and abuse provisions. In 2010 the law significantly expanded the government's authority to prosecute Faults Claims Act (FCA) cases. In 2011-2012 the ACA triggers increased provider screening, oversight and reporting. The ACA also establishes the Independent Payment Advisory Board to evaluate fee schedules and expands the scope of Medicaid and CHIP payments. 


Unlike most State compensation systems that presently struggle with both expeditious medical delivery as well the value and responsibility of medical care, the ACA provides a uniform system and expeditious system. The fragmented network of complex, dilatory and inconsistent results in the State programs have been described recently by national experts as "irrational" and "unjust."  They characterize the present compensation programs as "....dizzying and frustrating in its complexity, and apparent irrationality,"  and  they conclude that "a substantial proportion of persons with work-related disabilities do not receive workers' compensation benefits," and in need of a better format. 

Non-Traditional Revenue Stream
In addition to the widely publicized tax for non-compliance, the ACA contains several other innovative revenue provisions that will provide additional funding from collateral sources without burdening al employers globally. In 2010 an indoor tanning service tax was implemented. In 2011 annual fee was instituted on pharmaceutical companies as well as  an increased penalty for early withdrawal from health savings accounts. In 2013 the following provisions go into effect: the Medicare payroll tax will increase for high-income individuals, an excise tax on medical device manufacturers, limits on Flexible Spending Accounts, and the elimination of the deduction for Employer Part D subsidy. In 2014 there will be an annual fee on health insurance plans. In 2018 there will be an excise tax and high-cost plans commonly referred to as the "Cadillac tax."





"Libby Care"--Universal Care 
Center for Asbestos Related Disease
Libby, MT.
A provision of the Act, that has already been implemented, provides for the treatment of medical conditions, including asbestosis & mesothelioma, arising out the Libby, Montana asbestos contamination. The industrially caused   catastrophe in Libby has resulted in widespread illness and death. The ACA provides medical attention to those exposed to occupational toxins. The Center for Asbestos Related Disease is now operating in Libby, MT. The “Libby Care” provisions, and its envisioned prodigies, will embrace more exposed workers, diseases and geographical locations, than any other program of the past. This type of program, minimally, needs to be expanded to include all occupational illness nationally.



The Future: Universal Health Care
Landmarks on the Path to Federalization
It is very doubtful that ACA repeal legislation, to be offered by the Republicans in the House will pass Congress, nor will the President sign it.. There may be some technical and substantive revisions to the ACA in the next Congress. If there is a mixed political government after the next election,  the ACA will be implemented and go forward as the law of the land.


History reveals that a series of efforts have been made by the Federal government  to federalize medical care for industrial accidents and illnesses. Those efforts demonstrate a commitment to bring the nation ever closer to a universal care medical program incorporating the entire patchwork of workers' compensation medical delivery systems. The US Supreme Court has accelerated the nation down that promising path.
....
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). 

More on improving the medical delivery system

Jun 14, 2012
Yesterday the US Congress passed and sent to the President, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program. The Federally .
Dec 23, 2010
Yesterday the US Congress passed and sent to the President, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program. The Federally ...
Feb 15, 2011
In December 2010 US Congress passed and President Obama signed, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program.
Jul 05, 2010
The trend toward Federalization of workers' compensation benefits took a giant step forward by recent Presidential action creating the British Petroleum Oil Compensation Fund. While the details remain vague, the broad and ...

Jul 13, 2010
As The Path To Federalization expands, this debate will expand. A recent study by the Center for American Progress addresses these concerns. "Health threats from the oil spill may linger unseen, perhaps for more than a ...
Mar 16, 2011
Historically The Federal government's role has been to rise to the occasion and walk further down a path to federalization. On a smaller scale than the potential consequences of the Japanesse debacle, the US was first in line ...
Mar 05, 2011
Nationally, advocates to improve the delivery of medical benefits to injured workers have urged federalization of the medical delivery system into a single payer approach through universal health care. ... Compensation Claim Draws Major Public Attention (workers-compensation.blogspot.com); Vermont Governor Sets Out to Lead U.S. to True Universal Coverage (huffingtonpost.com); The World Trade Center Health Program Expands The Path to Federalization ...
Apr 03, 2010
The recent health care reform legislation provided for the Libby Care which will provide universal medical care for victims of asbestos related disease. The plan is a pilot program for occupational disease medical care fully ...
May 19, 2010
The “Libby Care” provisions, and its envisioned prodigies, will embrace more exposed workers, diseases and geographical locations, than any other program of the past. Potential pilot programs will now be available to ...

Related articles

Thursday, June 14, 2012

National Experts Call Workers Compensation System Irrational and Unjust

National workers' compensation experts, Law school Dean Emily A. Spieler and Professor John F. Burton, in a recently published article in the American Journal of Industrial Medicine conclude that the present that the present  workers' compensation systems is "irrational" and "unjust." 

Characterizing the program as "....dizzying and frustrating in its complexity, and apparent irrationality,"   they conclude that "a substantial proportion of persons with work-related disabilities do not receive workers' compensation benefits." They review such alternatives as universal medical care, "providing healthcare to workers regardless of the source of injuries or disease."


Related Articles on Alternative Compensation Programs
Dec 23, 2010
Yesterday the US Congress passed and sent to the President, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program. The Federally ...
Feb 15, 2011
In December 2010 US Congress passed and President Obama signed, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program.
Jul 05, 2010
The trend toward Federalization of workers' compensation benefits took a giant step forward by recent Presidential action creating the British Petroleum Oil Compensation Fund. While the details remain vague, the broad and ...
Jul 13, 2010
As The Path To Federalization expands, this debate will expand. A recent study by the Center for American Progress addresses these concerns. "Health threats from the oil spill may linger unseen, perhaps for more than a ...

Mar 16, 2011
Historically The Federal government's role has been to rise to the occasion and walk further down a path to federalization. On a smaller scale than the potential consequences of the Japanesse debacle, the US was first in line ...
Mar 05, 2011
Nationally, advocates to improve the delivery of medical benefits to injured workers have urged federalization of the medical delivery system into a single payer approach through universal health care. ... Compensation Claim Draws Major Public Attention (workers-compensation.blogspot.com); Vermont Governor Sets Out to Lead U.S. to True Universal Coverage (huffingtonpost.com); The World Trade Center Health Program Expands The Path to Federalization ...

Tuesday, January 24, 2012

Workers Compensation Fails to Cover Most Occupational Disease Claims

A just published study reports that only 25% of occupational disease claims are covered by US workers' compensation programs.

Click here to read the entire report: Economic Burden of Occupational Injury and Illness in the United States  Get PDF (611K)
"The medical and indirect costs of occupational injuries and illnesses are sizable, at least as large as the cost of cancer. Workers’ compensation covers less than 25 percent of these costs, so all members of society share the burden. The contributions of job-related injuries and illnesses to the overall cost of medical care and ill health are greater than generally assumed."