The New Jersey Division of Workers' Compensation set forth a policy statement defining the parameters for potential counsel fee recovery where The Centers for Medicare and Medicaid (CMS) is reimbursed for claims conditional payments by consent versus a judicial Order.
Click here to read the memo.
Friday, June 8, 2012
50 Cancers To Be Covered Under the 9-11 Zadroga Health Claim Fund
The New York Times is reporting this afternoon that The National Institute for Occupational Safety and Health (NIOSH) has approved for compensation payments 50 types of cancers from the $4.3 Billion Zadroga 9-11 Fund. The announcement was made by NIOSH WTC Program Director John Howard MD, whose agency was responsible for reviewing Petition 001 regarding the addition of cancer, or types of cancer, to the List of World Trade Center-Related Health Conditions.
The World Trade Center Health Program (WTC Health Program) was established by the James Zadroga 9/11 Health and Compensation Act of 2010. Right now, the program provides services for responders, workers, and volunteers who helped with rescue, recovery, and cleanup at the World Trade Center and related sites in New York City. It also provides services for survivors who lived, worked, or were in school in the area. The WTC Health Program soon will also serve responders to the 9/11 attacks at the Pentagon in Arlington, VA, and the Flight 93 crash site in Shanksville, PA.
Medical clinics are maintained throughout the New York metropolitan area. For a list of clinics click here.
Next Steps:
Once the Administrator receives the Advisory Committee’s recommendation he has 60 days to publish in the Federal Register either a notice of proposed rulemaking regarding the recommendation or a determination not to propose a rule and the basis for that determination.
If the Administrator publishes a notice of proposed rulemaking to add cancer, or certain types of cancer, to the List of WTC-Related Health Conditions, the WTC Health Program must follow the normal regulatory process, including a minimum 30 day public comment period and review of those comments, before issuing a final rule.
If the Administrator determines not to add a certain type of cancer to the List of WTC-Related Health Conditions at this time there would still be the possibility that the type of cancer could be added to the List of WTC-Related Health Conditions in the future. Such potential future additions could be initiated through new petitions to the Administrator or at the Administrator’s discretion.
List of Cancers:
▪ Malignant neoplasms of the lip, tongue, salivary
gland, floor of mouth, gum and other mouth, tonsil,
oropharynx, hypopharynx, and other oral cavity and
pharynx
▪ Malignant neoplasm of the nasopharynx
▪ Malignant neoplasms of the nose, nasal cavity,
middle ear, and accessory sinuses
▪ Malignant neoplasm of the larynx
▪ Malignant neoplasm of the esophagus
▪ Malignant neoplasm of the stomach
▪ Malignant neoplasm of the colon and rectum
▪ Malignant neoplasm of the liver and intrahepatic
bile duct
▪ Malignant neoplasms of the retroperitoneum and
peritoneum, omentum, and mesentery
▪ Malignant neoplasms of the trachea; bronchus and
lung; heart, mediastinum and pleura; and other illdefined sites in the respiratory system and
intrathoracic organs
▪ Mesothelioma
▪ Malignant neoplasms of the soft tissues (sarcomas)
▪ Malignant neoplasms of the skin (melanoma and nonmelanoma), including scrotal cancer
▪ Malignant neoplasm of the breast
▪ Malignant neoplasm of the ovary
▪ Malignant neoplasm of the urinary bladder
▪ Malignant neoplasm of the kidney
▪ Malignant neoplasms of renal pelvis, ureter and
other urinary organs
▪ Malignant neoplasms of the eye and orbit
▪ Malignant neoplasm of the thyroid
▪ Malignant neoplasms of the blood and lymphoid
tissues (including, but not limited to, lymphoma,
leukemia, and myeloma)
▪ Childhood cancers
▪ Rare cancers
....
For over 3 decades the Law Offices of Jon L. Gelman1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered work related accident and injuries.
Wednesday, June 6, 2012
Congressman Cummings Introduces Legislation to Reform Defense Base Act
“There is absolutely no reason American taxpayers should be lining the pockets of private insurance companies,” said Cummings. “This bill would save billions of dollars while improving the ability of contractor employees who risk their lives in war zones to obtain the medical care and support they deserve.”
According to a 2009 Pentagon study, Congress could save as much as $250 million a year by transitioning the existing Defense Base Act (DBA) insurance program to a government self-insurance program. The study found: “In the long run, the self-insurance alternative may have the greatest potential for minimizing DBA insurance costs, and it has several administrative and compliance advantages as well.”
Cummings’s legislation, H.R. 5891, The Defense Base Act Insurance Improvement Act of 2012, would direct the Departments of Defense and Labor to establish a self-insurance program in which the government would pay directly for medical benefits and disability benefits rather than utilizing private insurance companies.
The existing system has been a boondoggle for private insurance companies, who have reaped enormous profits under the program. According to an Oversight Committee investigation, insurance companies providing DBA insurance in Iraq and Afghanistan have made enormous underwriting profits that are significantly higher than those of traditional workers’ compensation insurers.
The current DBA system requires contractors to purchase workers’ compensation insurance for employees working overseas from private insurance carriers, and the contractors and insurance companies negotiate their own rates. Since the costs of the insurance premiums are often built into the price of the contract with the government, there is little incentive for contractors to limit insurance costs.
Cummings’s bill would set a six month deadline for the Departments of Defense and Labor to develop an implementation strategy to transition to a self-insurance program, and it would require the strategy to be executed within a year after the bill is enacted.
The legislation would also require the Departments of Defense and Labor to issue a report one year after the program is implemented to assess its effectiveness in terms of cost-savings and the delivery of benefits.
In addition to cost concerns, the current system has failed to ensure that all injured workers obtain health care services, disability payments, or death benefits they and their families deserve. An analysis by ProPublica found that private insurance companies had denied about 44% of serious injury claims and about 60% of claims by employees suffering psychological damage such as post-traumatic stress disorder.
Tuesday, June 5, 2012
AIG settles workers compensation insurance complaint with all 50 states, DC for $146.5M
The Office of Insurance Regulation (Office) will receive $5.6 million in fines and penalties with an additional $8.7 million split between the Department of Financial Services (DFS) Division of Workers’ Compensation, Department of Revenue (DOR) and the Florida Workers’ Compensation Insurance Guaranty Association (FWCIGA).
"AIG systematically underreported workers' compensation insurance premium by putting this premium into the general liability or commercial automobile liability categories,” stated Commissioner McCarty. "The practical effect of this misreporting was to report premium in lines of business with lower residual market obligations or premium tax rates and assessments. I am pleased by the collaborative multi-state investigative effort that will yield millions of dollars in unpaid taxes owed to the states."
The lead states issued their multi-state examination report in December 2010 and entered into a related regulatory settlement agreement. The agreement was subject to several conditions, all of which have now been resolved. One of those was a $450 million residual market settlement that was approved by the U.S. District Court in February 2012. The remaining open condition, a settlement with insurance guaranty associations, was satisfied on May 30, 2012 when a $25 million settlement agreement was signed.
Florida was one of the lead states in this multistate examination along with Delaware, Indiana, Massachusetts, Minnesota, New York, Pennsylvania, and Rhode Island. As part of the agreement, AIG entered into a compliance plan concerning the financial reporting of its workers’ compensation premium, and going forward agreed to be monitored and subject to a follow-up examination by the lead states in two years.
Thursday, May 31, 2012
California Settlement Protects Hair Salon Workers
The settlement with the manufacturer of Brazilian Blowout products requires the company to warn consumers and hair stylists that two of its hair smoothing products emit formaldehyde gas, which is known to cause cancer in humans. The company must also cease deceptive advertising; pay $600,000 in fees, penalties and costs; and report the presence of formaldehyde in its products to California Safe Cosmetics Program (CSCP) (http://www.cdph.ca.gov/programs/cosmetics/Pages/default.aspx). The warning requirements are the maximum penalty that could be achieved under state law.
The January 2012 settlement stemmed from complaints from hair stylists and customers that the product was causing symptoms, including nose bleeds, burning eyes and throat, skin irritation, and asthma attacks.
See http://www.cdph.ca.gov/programs/cosmetics/Documents/BrazilianBlowoutQA.pdf for more on Brazilian Blowout. Email OHW@cdph.ca.gov to subscribe to the monthly Occupational Health Watch e-newsletter.
....
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 work related accident and injuries.
Home Hospitalization
With the soaring cost of workers' compensation payments now exceeding 50% of payments, new and innovative approaches are being advanced.
Click here to read more: Some Patients Can Choose To Be Hospitalized At Home
Related articles
China: Employer Pays Compensation After Murdering Employee
The family of a deceased migrant worker was compensation after street protests following the murder of the employee by the Chinese employer.
Click here to read more: Zhejiang protest ends with compensation deal
"Migrant workers' protests that broke out on Monday in east China's Zhejiang province following a peer's death have mostly come to an end and the family of the deceased has received 300,000 yuan (47,298) in compensation, local authorities said Tuesday."
Subscribe to:
Posts (Atom)