Copyright
Tuesday, June 30, 2009
Labor and Industry Join Forces to Change the Path of Health Care Delivery
The nation’s largest private employer, Walmart (non-union), and the nation’s largest union representing health care workers, SEIU, as well as the influential policy think-tank, the Center for American Progress, delivered a letter to President Obama today, endorsing a mandate for employer and employee contribution for a health care plan.
Citing the Senate Finance Committee (Max Bacus (D-Montana, Chairman) that “health care expenditures are expected to consume nearly 20 percent of the GDP” by 2017, the collation seek, “…an employer mandate which is fair and broad in its coverage.”
While the debate is being to flow in the direction of the adoption a “public plan” option, the “single payer system” has not yet been ruled out entirely. Funding continues to remain a concern.
It is anticipated that if a “public plan” is adopted, the workers’ compensation system will probably be targeted as an economic engine to contribute generated revenue through various reimbursement mechanisms in addition to outright payment reform including incentive based medicine. It is estimated that the plan's cost may amount to a $2 Trillion cost.
Cost shifting enforcement could be more strictly pursued. Additional fines, penalties and user fees, maybe assessed under the Medicare Secondary Payer Act. Even taxing workers’ compensation benefits may become an option if other employer provided health care benefits are also subject to tax.
Saturday, June 27, 2009
OSHA Fines Metro North $300,000 for Retaliation Against Injured Workers
Friday, June 26, 2009
Court Sets Proof Standard for Medical Bill Review
(a) A billing review service shall adhere to the following requirements to determine the pecuniary liability of an employer or an employer‟s insurance carrier for a specific service or product covered under worker‟s compensation:
(1) The formation of a billing review standard, and any subsequent analysis or revision of the standard, must use data that is based on the medical service provider billing charges as submitted to the employer and the employer‟s insurance carrier from the same community. This subdivision does not apply when a unique or specialized service or product does not have sufficient comparative data to allow for a reasonable comparison.
(2) Data used to determine pecuniary liability must be compiled on or before June 30 and December 31 of each year.
(3) Billing review standards must be revised for prospective future payments of medical service provider bills to provide for payment of the charges at a rate not more than the charges made by eighty percent (80%) of the medical service providers during the prior six (6) months within the same community. The data used to perform the analysis and revision of the billing review standards may not be more than two (2) years old and must be periodically updated by a representative inflationary or deflationary factor. Reimbursement for these charges may not exceed the actual charge invoiced by the medical service provider. 7
(4) The billing review standard shall include the billing charges of all hospitals in the applicable community for the service or product.
Thursday, June 25, 2009
Mesothelioma Compensation Rate 32% in Canada
Defense Bar Floods the US Supreme Court With Amicus Briefs in RICO Case
Wednesday, June 24, 2009
California Governor Reportedly Wants to Sell The State Insurance Fund
Saturday, June 20, 2009
US Supreme Court Bars Direct Asbestos Claims Against Travelers Insurance
The US Supreme Court ruled that the direct action claims against Travelers Insurance Company for its conduct in the asbestos conspiracy with Johns-Manville Corporation (Manville) were barred by the 1986 reorganization plan of the Manville.