Holes in the Safety Net — Legal Immigrants' Access to Health Insurance

Immigrant workers are entitled to workers' compensation benefits in most jurisdictions even if they are in the US without status. Ongoing Congressional changes to the nation's immigration system will have significant impact on the delivery of healthcare to immigrant workers.Today's post was shared by NEJM and comes from www.nejm.org

While Congress debates whether publicly supported health care should be available to undocumented immigrants who may be placed on a path to citizenship under immigration reform, the health care needs of already legal immigrants continues to be overlooked.

More than 12 million immigrants are lawfully present in the United States. They serve in the military, pay taxes, and contribute to the economy. Yet like undocumented immigrants, whose health care vulnerabilities are outlined in the Perspective article by Sommers, legal immigrants face substantial barriers to obtaining insurance coverage (see graph Health Insurance, According to Citizenship Status, 2009.). As a result, some — such as Antonio Torres, an uninsured Arizona farmworker who was in a coma after a car accident — have been forcefully transferred to their native country when their treating hospitals were unable to find facilities willing to provide them with long-term care.1

HHS Inspector General Scrutinizes Medicare Observation Care Policy

Medical treatment costs paid in workers' compensation claims continue to exceed 50% of the losses paid. The Federal government is attempting rein in medical costs generally. Those efforts will impact workers' compensation medical payments. Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org

Medicare patients' chances of being admitted to the hospital or kept for observation depend on what hospital they go to -- even when their symptoms are the same, notes a federal watchdog agency in a report to be released today, which also urges Medicare officials to count those observation visits toward the three-inpatient-day minimum required for nursing home coverage.

The investigation, conducted by the Department of Health and Human Services Inspector General, was based on 2012 Medicare hospital charges. Its findings, which underscore several years of complaints that the distinction between an inpatient and observation stay isn't always clear, come just days before the Centers for Medicare and Medicaid Services (CMS) is expected to issue final regulations intended to address the problem.

Those rules, proposed in April, would assume that patients who stay two nights or longer in the hospital are inpatients. Those who have shorter stays would receive observation care, an outpatient service. However, the IG report said the proposal, which has been criticized by hospital, physician and consumer groups, would not reduce the number of observation stays.

An observation patient can be treated in the emergency room or on an inpatient unit in the hospital. CMS does not require hospitals to tell patients they are receiving observation services, which the IG's analysis said can include some of the same procedures provided to admitted patients.

"Some...

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More states report Cyclospora cases; total reaches 373

Today's post was shared by CIDRAP and comes from www.cidrap.umn.edu

Arkansas, Florida, Missouri, and New York City have reported their first Cyclospora infections with possible ties to a multistate outbreak, raising the nation's total to as many as 373, according to the latest information from federal and state sources.

The US Centers for Disease Control and Prevention (CDC) in an update today said it had received reports of 353 cases as of Jul 26, but Iowa, Nebraska, and Texas have reported more cases since then.

So far 21 patients from three states have been hospitalized, but no deaths have been reported. The CDC said illness onset dates have ranged from the middle of June to early July.

No food source has been identified yet, but health officials in Iowa—the state reporting the most cases—have said they suspect imported vegetables. Cyclospora is an extremely rare parasite, and past outbreaks have been linked to imported fruit or vegetables.

The Food and Drug Administration (FDA) said in a Jul 26 notice that it, along with the CDC and state and local departments, was investigating the multistate outbreak.

So far it's not clear if cases from all of the states are part of the same outbreak. Some of the cases in Iowa and Nebraska have tentative links to foreign travel, and some of the sick patients in Illinois, Kansas, and Missouri may have become ill after travel to other states that have reported dozens of cases.

The Florida Department of Health (FDH), which reported its first cases on Jul 26, said its epidemiologists are...

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OSHA and NIOSH issue hazard alert on 1-bromopropane

The U.S. Department of Labor's Occupational Safety and Health Administration and the National Institute for Occupational Safety and Health today issued a hazard alert to urge employers that use 1-bromopropane (1-BP) to take appropriate steps to protect workers from exposure.

"The use of 1-bromopropane has increased in workplaces over the last 20 years," said Dr. David Michaels, assistant secretary of labor for occupational safety and health. "Workers exposed to this toxic chemical can suffer serious health effects, even long after exposure has ended. Hazardous exposure to 1-BP must be prevented. Employers have a responsibility to ensure the safety of their workers."

Exposure to 1-BP has been associated with damage to the nervous system among workers, and it has been shown to cause reproductive harm in animal studies. The chemical is used in degreasing operations, furniture manufacturing, and dry cleaning. The hazard alert was issued in response to information on the increased use of 1-BP as a substitute for other solvents as well as recent reports of overexposure in furniture manufacturing. 1-BP was nominated as a chemical of concern in OSHA's Web Forum to Identify Hazardous Chemicals.

Workers can be exposed to 1-BP by breathing in vapors or spray mists and by absorption through the skin. The most effective way to protect workers from exposure is to eliminate the use of 1-BP, substituting the chemical with a less toxic substance or less hazardous material. Replacement chemicals also may have associated hazards that need to be considered and controlled.

Engineering controls to reduce worker exposure to 1-BP include isolation of workplace operations and the installation of proper ventilation systems. Other controls, such as a reduction in the time a worker is exposed to the chemical, should also be considered

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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. 

English: image edited to hide card's owner name. author: Arturo Portilla (Photo credit: Wikipedia)

" 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

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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...

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Related articles

• "Opting Out" of Worker's Compensation Hurts Workers and Employers (Part 1)
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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

• Background
• General PPE Guidance
• General Worker Safety Guidance
• Additional Information
• 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

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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