Medical Fees: Does One Price Fit All?

The Federal government has proposed a simplified medical billing process that may impact workers' compensation billing practices going forward. Most workers' compensation fee medical fee schedules are linked either directly and indirectly the to Federal Medicare model and a proposed Rule published last week in the Federal Register proposes a single fee for all office visits.

New Jersey workers' compensation judge has ordered this municipality to cover the cost of a municipal employee's medical marijuana

Today's post is shared from http://nj1015.com

"A New Jersey worker's compensation judge has ordered this municipality to cover the cost of a municipal employee's medical marijuana, saying that the federally banned weed is safer than prescription painkillers.

When A Judge Says “Appeal Me” and Commits Reversible Error

A judge of compensation must include in its decision the reasonable basis for reaching a conclusion.

The New Jersey Appellate Court, in a per curium, unreported ruling, reversed the decision of a New Jersey judge of compensation who awarded a reduced counsel fee of 15% of the total award without explanation. The two-judge appellate tribunal held that the judge of compensation appeared to be “antagonistic” to injured worker’s attorney when the attorney asked the hearing officer for an explanation of the fee reduction.

Insufficient Evidence: When "A Lot" is Not Enough

A Judge of Compensation's opinion must be supported by objective medical evidence and not merely based upon an inadmissible net opinion of a medical expert.

NJ Legislature Sends Workers' Compensation Counsel Fee Bill to Governor

This bill would require, in cases in which a workers’ compensation petitioner has received compensation from an insurance company or self-insured employer prior to any judgment or award, that the reasonable attorney fee be based upon the amount of the compensation received after the establishment of an attorney-client relationship (as memorialized in a written agreement), plus any amount of the judgment or award which is in excess of the previously received compensation. Under current law, in such cases involving insurance or self-insurance compensation, the attorney fee is based solely on any amount of a judgment or award that is in excess of the amount of previously received compensation.

Penalty Denied in MSP Private Cause of Action Claim for Delay in Reimbursement

While the personal representative of an estate had standing to bring a lawsuit against a medical provider for recoupment of money under the Medicare Secondary Payer Act [MSP], it was unable to seek double damages for delay in reimbursement of the money paid.

Massachusetts Sues Purdue Pharma for Illegally Marketing Opioids and Profiting From Opioid Epidemic

More than 670 Massachusetts Residents Prescribed Purdue Opioids Died from Opioid-Related Overdoses since 2009; Purdue Sales Reps Made 150,000 Visits to Medical Offices Since 2008, Sold 70 Million Doses Generating $500 Million in Revenue

Attorney General Maura Healey sued Purdue Pharma L.P. and Purdue Pharma Inc. (Purdue) for misleading prescribers and consumers about the addiction and health risks of their opioids, including OxyContin, to get more people to take these drugs, at higher and more dangerous doses, and for longer periods of time to increase the companies’ profits.