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(c) 2010-2024 Jon L Gelman, All Rights Reserved.

Thursday, June 27, 2013

CMS Consolidates Web Portals for Coordination of Benefits & Recovery

The Coordination of Benefits and Medicare Secondary Payer Recovery sections on the Medicare tab of the CMS.Gov Web Site have been combined into a single, comprehensive section titled, Coordination of Benefits & Recovery.  

The Web Site redesign consolidates information into groupings by audience and topic. To
access the new web pages, go to www.cms.gov and click on the Medicare tab near the top of the page. Once the Medicare page loads, scroll down to the Coordination of Benefits & Recovery section and select any of the links available.

CMS provides the ability for you to be automatically notified when changes are made to a section under Coordination of Benefits & Recovery. 

To sign-up for these notifications, select one of the Web Site links (e.g. Insurer Services) and click on the Sign-up Notification link found in the Related Links area near the bottom of the page. You will be asked to supply your email address and then be taken to a selection page. Scroll to the Coordination of Benefits & Recovery heading and select the section or sections for which you wish to receive notifications. When new information is added to a section you have selected, you will be notified via email.

For those users that regularly visit the Web Site, short-cut links have been created for ease of access:

Coordination of Benefits & Recovery Overview: http://go.cms.gov/cobro  

Attorney Services:  http://go.cms.gov/attorney

Beneficiary Services:   http://go.cms.gov/bene

COBA Trading Partners:  http://go.cms.gov/cobatp

Employer Services:  http://go.cms.gov/employer

Insurer Services:  http://go.cms.gov/insurer

Prescription Drug Assistance Programs:   http://go.cms.gov/pdap

Provider Services:   http://go.cms.gov/provider
  
Mandatory Insurer Reporting For Group Health Plans:  http://go.cms.gov/mirghp 

Mandatory Insurer Reporting For Non Group Health Plan:  http://go.cms.gov/mirnghp

Workers’ Compensation Medicare Set-Aside Arrangements:  http://go.cms.gov/wcmsa


Wednesday, June 26, 2013

Serious Safety Hazards Results in $49,600 in Fines for Paterson NJ Contractor

The U.S. Department of Labor's Occupational Safety and Health Administration has cited Paterson-based R.E. General Contractor LLC for alleged repeat and serious violations of occupational safety standards found while workers replaced a roof on a commercial building at 500 Grand St. in Paterson. The general contractor faces a total of $49,600 in proposed fines following a December 2012 imminent danger inspection by OSHA's Hasbrouck Heights Area Office.

Two repeat violations, with a $46,800 penalty, were cited for exposing workers to fall hazards of
approximately 50 feet while workers engaged in roofing work without fall protection in place. Workers also used an extension ladder that did not extend at least 3 feet above the upper landing surface. A repeat violation exists when an employer previously has been cited for the same or a similar violation of a standard, regulation, rule or order at any other facility in federal enforcement states within the last five years. OSHA cited similar violations in 2008, 2010 and 2011.

One serious violation, carrying a $2,800 fine, resulted from the failure to provide workers with hard hat protection while working near the forks of a material boom lift. A serious violation occurs when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known.

"OSHA will not tolerate this company's continuous disregard for adequate fall protection," said Lisa Levy, director of OSHA's Hasbrouck Heights Area Office. "Employers have a responsibility to ensure that workers exposed to fall hazards are provided with the proper fall protection equipment, are trained in its use and wear it whenever a fall hazard is present."

OSHA has created a Stop Falls Web page at http://www.osha.gov/stopfalls with detailed information in English and Spanish on fall protection standards. The page offers fact sheets, posters and videos that vividly illustrate various fall hazards and appropriate preventive measures.

R.E. General Contractor LLC has 15 business days from receipt of the citations to comply, request an informal conference with the OSHA area director in Hasbrouck Heights, or contest the citations and proposed penalties before the independent Occupational Safety and Health Review Commission.

Read more about OSHA and workers' compensation.
Jan 16, 2013
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Dec 20, 2012
"The employee testimony for the follow-up abatement inspection, required by a subpoena, allows OSHA inspectors to determine if SeaWorld employees continue to be exposed to unsafe and unhealthy working conditions," ...
Jan 10, 2013
The results of this first round of sampling show that while some contaminants were present, such as carbon monoxide, asbestos and silica, they have so far not exceeded any of OSHA's Permissible Exposure Limits, which can ...

NJ Workers Compensation Companies Pay More for Hospital Fees

NJ workers' compensation insurance companies pay more for hospital charges than group health plans, according to a recent study published by the WRCI. NJ workers' compensation statute mandates a closed panel system were the the company must authorize the medical provider.

"The average workers' compensation payment for shoulder surgery in New Jersey was $7,323. Group health plans paid only $4,583 on average, a difference of $2,740, or 37 percent less.

For knee surgery the workers' compensation insurers' cost was $5,547, 42 percent higher than amounts paid through group health plans, which included the co payments and deductibles paid by the patients."

Click here to read: "Study: NJ workers comp insurers pay higher fees to hospitals than group insurers" The Record

Read more about medical treatment and workers' compensation:
Proposed Medicare Payment Reductions Will Impact Workers
Jun 17, 2013
A government Medicare advisory panel reported on Friday that sweeping changes should be implemented to reduce increasing medical costs, including higher costs associated with hospital purchased physician practices.
http://workers-compensation.blogspot.com/


NJ Bayonne Medical Center - Highest Priced Medicine in the Nation
May 18, 2013
The cost of medical care has increased tremendously according to a recently issued report. The NCCI (National Council on Compensation Insurance Inc.) reports an increase in medical costs from 40% in the early 1980s to .
http://workers-compensation.blogspot.com/


Workers' Compensation Jeopardy: Romney and Medical Costs
Nov 01, 2012
Planned changes by Mitt Romney to Medicare and Medicaid will have a dire effect on the regulations of the future cost of workers' compensation medical treatment. Proposed changes to the Federal program will indirectly ...
http://workers-compensation.blogspot.com/


Workers' Compensation: Medical Costs Soar in Workers ...
Dec 11, 2008
The cost of medical care has increased tremendously according to a recently issued report. The NCCI (National Council on Compensation Insurance Inc.) reports an increase in medical costs from 40% in the early 1980s to ...
http://workers-compensation.blogspot.com/


Related articles

Monday, June 24, 2013

OSHA settles with Nebraska-based ConAgra Foods to protect workers from anhydrous ammonia

ConAgra Foods, Inc. dba Lamb Weston, Inc. has signed a settlement agreement with the U.S. Department of Labor's Occupational Safety and Health Administration to protect workers at five of its facilities from the release of anhydrous ammonia from refrigeration systems.

The agreement protects workers at Idaho, Arkansas, Missouri and Ohio facilities of the Nebraska-
based company. It requires ConAgra to implement controls to reduce hazards associated with release of ammonia from low pressures receivers.

"This agreement ensures that ConAgra will protect workers from releases of ammonia by enclosing older LPRs that were not already enclosed, and by providing other controls such as normal and emergency ventilation to prevent exposure," said Assistant Secretary of Labor for Occupational Safety and Health Dr. David Michaels. "OSHA's corporate-wide settlement agreements are highly effective tools for ensuring that companies take a systemic approach to addressing hazards that can injure or kill their workers."

OSHA's Process Safety Management standard requires employers to document that equipment that was designed to meet codes and standards no longer in general use is still safe to operate under OSHA standards. OSHA originally cited ConAgra for failing to determine whether these older LPRs were being operated safely.

Under the agreement, ConAgra will implement administrative and engineering controls at the covered LPRs to control hazards associated with the release of ammonia. This includes building enclosures around equipment that is not already enclosed. Each enclosure must include normal and emergency ventilation that meets specified requirements, automatic switches for both normal and emergency ventilation and ammonia detection alarms. Egress doors for the enclosures will be required to include panic hardware and to swing in the direction of egress.

The agreement is the result of an inspection conducted at the company's American Falls, Idaho, facility, initiated under OSHA's PSM Covered Chemical Facilities National Emphasis Program, established to reduce or eliminate the workplace hazards associated with the catastrophic release of highly hazardous chemicals.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA's role is to ensure these conditions for America's working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit http://www.osha.gov.

Read more about "ammonium:
Dec 01, 2012
Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic (cancer-causing), including formaldehyde, benzene, vinyl chloride, arsenic, ammonia, and hydrogen cyanide. Secondhand smoke has .
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Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic (cancer-causing), including formaldehyde, benzene, vinyl chloride, arsenic, ammonia, and hydrogen cyanide. Secondhand smoke has .
Feb 20, 2008
Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic (cancer-causing), including formaldehyde, benzene, vinyl chloride, arsenic, ammonia, and hydrogen cyanide. Secondhand smoke has ...


The 12 Things You Must Do If You Are Hurt At Work

Today's post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm.

Injured workers call me all the time asking me what they need to do to make sure they protect their legal rights.  If you are hurt on the job, whether it is due to an acute traumatic injury (like cutting yourself on a saw), cumulative-trauma injury (like carpal-tunnel syndrome) or some other job-related injury, there are several basic things you should do. If you do not do any of the things on the list below, you may lose your rights under workers’ compensation law

Although there may be rare exceptions to this list,  following it will leave you reasonably secure that your rights are protected:
  1. Report the injury. By “injury,” I mean almost any condition including but not limited to (a) an acute traumatic injury, (b) a cumulative-trauma injury, or (c) a disease or a hearing loss. You should report the injury to your supervisor or company nurse (for clarity we’ll just call these people your Supervisor from here on out), making clear your injury was caused by work. Under Iowa law, you need to make the report within 90 days of the date of your injury.
  2. Make sure your Supervisor prepares a company accident report.  If your Supervisor won’t prepare the report,

Sunday, June 23, 2013

NJ Workers' Compensation Judge Looses Her Own Case

A NJ Workers' Compensation judge was denied benefits after sustaining injuries as a result of a motor vehicle accident while traveling from her home to a NJ workers' compensation district courthouse that she was supervising.  

The Appellate Court, affirming a trial court dismissal, ruled, that even though the judge was afforded mileage reimbursement. The Court stated that there was no proof that her commute to work was part of her actual work day. It also  reasoned that there was no "special hazards" incurred by the travel, nor was it considered a "special mission." Therefore, the denial of benefits was affirmed under the "coming and going" rule.

Audrey Kernan v. State of NJ, Docket A-4261-11T4 (Decided June 19, 2013)

Read more about "The Coming and Going Rule" and workers' compensation:

Single Payer A Possibility for New York City Employees

The single payer medical benefit system, a program that brings workers compensation into a universal care program, maybe the future for NY City employees. Anthony D. Weiner, a Democratic Candidate, is proposing the change.

"Vowing to “make New York City the single-payer laboratory in the country” if he is elected
mayor, Anthony D. Weiner on Thursday presented an ambitious plan to create a Medicare-like system for the coverage of municipal workers, retirees and uninsured immigrant residents left out of the Affordable Care Act."

Click here to read: "Weiner Wants City to Test Single-Payer Health Care" The NY Times