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Workers' Compensation News


Goldstein: Proposals Will Likely Increase Medicare Advantage Plan Enrollment 02/12/2019
Source: Jean S. Goldstein
State: NA | Segment: Top | 269 | 0
The Centers for Medicare and Medicaid Services recently released Part II of a set of proposals that CMS indicates “will take significant steps in continuing the agency’s efforts to maximize competition among Medicare Advantage Plans (MAP) and Part D plans.” ...Read More

Moore: Where Small Claims Can Turn to Crises 02/11/2019
Source: James Moore
State: NA | Segment: Top | 178 | 0
Most medical-only claims adjusting sections in a claims processing manual consist of very few pages. Lost time adjusting takes up the majority of a third-party administrator or insurance carrier claims manual. ...Read More
Lynch: The Wizard Behind The Curtain, Part 1 02/07/2019
Source: Tom Lynch
State: NA | Segment: Top | 96 | 0
Suddenly, everybody’s out to get pharmacy benefit managers: the Centers for Medicare and Medicaid Services, state legislatures, state Medicaid officials, a boatload of experts and even President Donald Trump, who appears to actually and sincerely believe PBMs have created a rigged system....Read More

Siefkes: Catastrophic or Not? 02/06/2019
Source: W. Robert Siefkes
State: CA | Segment: Top | 261 | 0
I recently resolved a case involving a health care worker’s exposure to the measles virus during the course of her usual and customary work activities. It caused rather substantial neurological impairments. The neurologic injuries were accepted. ...Read More

Paduda: What Is Transparency? 02/05/2019
Source: Joe Paduda
State: NA | Segment: Top | 268 | 0
Buyers are asking health care intermediaries for “transparency.” I’ll try to concisely describe what this transparency thing is. ...Read More

Gorman: Let's Cap the Well 02/04/2019
By: Patrick C. Gorman
State: CA | Segment: Top | 373 | 1
We have been seeing a cottage industry in the area of non-independent bill review medical-legal disputes over the past three years. ...Read More

Thompson: A Bill of Rights to Limit Absurd Managed Care Fees 02/01/2019
By: Barry Thompson
State: NA | Segment: Top | 185 | 0
A properly incentivized third-party administrator must share in the challenge of a claim and not profit from failure. Limitless managed care fees provide no credible incentive to resolve work comp claims. ...Read More

Langham: Limine and Workers' Compensation 01/31/2019
Source: David Langham
State: NA | Segment: Top | 119 | 0
In American legal proceedings there are debates of law and facts. The fact debates can be illustrated easily enough. ...Read More

Grinberg: Injured Worker Can Use Phone to Record QME Exam 01/30/2019
Source: Gregory Grinberg
State: CA | Segment: Top | 385 | 0
So many of our litigated workers’ compensation cases turn on the medical-legal exam.  Everyone knows that every single chiropractic qualified medical evaluators will find every injury results in 100% disability that is industrially caused, while every spine and orth...Read More

Duff: The 'Entrepreneurial Opportunity' Canard 01/29/2019
By: Michael C. Duff
State: NA | Segment: Top | 295 | 0
The world of workers' compensation is always well-served to keep abreast of labor and employment law developments outside of its ordinary confines.  ...Read More
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