Understanding the California Medical Treatment Utilization Schedule (MTUS)
At the 2015 California Coalition on Workers’ Compensation Conference, Denise Zoe Algire from Safeway and Dr. Lawrence Miller from Anthem Workers’ Compensation presented a session entitled California MTUS: Past, Present Future. The primary goal of adopting treatment guidelines should not be cost containment. The primary goal should be to expedite the injured worker receiving the appropriate treament. The MTUS guidelines have been in place for a number of years and they are specific to California. Treatment guidelines should follow evidence-based medicine, which is healthcare based on clinical studies of which treatments are the most effective for different conditions. Recently, we
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Defending Psych/Stress Claims
At the 2015 California Coalition on Workers’ Compensation Annual Conference, Dr. David Hall and Marc Liebowitz from the law firm Laughlin, Falbo, Levy & Moresi presented a session titled, “Psych/Stress Claims – How Not to Go Crazy Just Because Your Employee Did.” This session addressed the interplay between medical and legal issues in California with the defense and timely resolution of psychiatric claims. Understanding what drives a psych claim: Money. Time away from work. Resonse to physical injury. Frustration at work. Catalyst for non-industrial issues to be aggrivated or exacerbated. Certain personality types lend themselves to someone who will file
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Medical Marijuana in States
An all-star cast was in place to discuss the medical marijuana trend at the SAWCA 67th Annual Convention. Paul Tauriello, Colorado Director of Workers’ Compensation, opened the session with an overview of Colorado’s medical marijuana industry, which ended the 2014 year with sales of approximately $386 MM. He noted that getting qualified applicants for law enforcement and related positions has been tough due to drug testing requirements and that this could be a concern in the future. Paul introduced Michael Newman, a 21-year old student who overcame cancer and used FDA-approved Marinol to control his nausea while fighting and overcoming
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What is a Formulary and How Does a State-Adopted Formulary Work For You?
At the 2015 California Coalition on Workers’ Compensation Annual Conference (CCWC), a panel discussed the pros and cons of a state-adopted pharmacy formulary. Panelists included Dr. Bernyce Peplowski and Alex Swedlow from CCWC and Brenda Wood and Karen Caterino from Healthcare Solutions. A workers’ compensation formulary is designed to be specific for industrial injuries and provides a list of drugs that will be reimbursed without prior authorization or adjuster approval. Drugs not included in the formulary require pre-authorization prior to being dispensed. If the formulary is set up properly, it will reduce administrative burden and costs and ensure that the
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Day 2 at SAWCA
Wednesday, July 22nd was an action-packed day at the SAWCA 67th Annual Convention. The day began with cyber discussions led by Bary Dalton from Federal Reserve Bank – Richmond, and Susan Gordon from Zurich NA. This session provided insight on the current cyber threats and why this has emerged so quickly in the marketplace. As businesses try to connect to customers, suppliers and other users, they have expanded their potential access points thereby expanding the opportunities for hackers to penetrate businesses information and data systems. The expected insurance growth in cyber and cyber-related insurance will increase from approximately $2 billion
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California Workers’ Compensation – North vs South
At the 2015 California Coalition on Workers’ Compensation Annual Conference, a panel discussed the huge disparity in claims costs between northern and southern California. The panel consisted of: Alfonso Moresi – Commissioner, Workers’ Compensation Appeals Board and partner in law firm Laughlin, Falbo, Levy and Moresi Richard Newman – Chief Judge for the California Department of Industrial Relations Mark Priven – Principal with Bickmore Risk Services The litigation rates in Southern California are much higher than the rest of the state, accounting for approximately 75% of the total court opening filings statewide. Along the same lines, the number of workers’
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CCWC Legislative and Political Update
The 2015 California Coalition on Workers’ Compensation Annual Conference (CCWC) kicked off with a Legislative and Political Update presented by Paul Yoder and Jason Schmelzer from CCWC. In the last year, there have been four out of 40 members of the State Senate who were suspended for misconduct. This resulted in the Democrats losing their super majority in the Senate. Governor Brown is in his fourth and final term as Governor. Although he does not plan on running for any additional political offices, he has almost $20 million in campaign funds in the bank. He retains a 52% approval rating
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What Will Workers’ Compensation Look Like in 20 Years?
At the 67th Annual SAWCA Convention, Frank Neuhauser, Executive Director of the Center for the Study of Social Insurance (CSSI) at University of California at Berkeley, opened this keynote session by discussing the future of workers’ compensation. Workers’ Compensation’s Inefficient Delivery He noted that the current system does not efficiently address the issues that employers and employees face today. In 1915, the system was primarily created to support a heavily industrialized workforce, which is no longer the case. The organizational costs associated with administering $1.00 of medical treatment under workers’ compensation is estimated to be $1.25 versus .14 cents to
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CCWC’s 13th Annual Conference: Legislative & Educational Forum
Safety National will attend the 13th Annual California Coalition on Workers’ Compensation (CCWC) Conference on July 22-24 in Anaheim, CA., where we will sponsor, present and blog on sessions through Conference Chronicles. The CCCWC is dedicated to providing the leadership, education, and advocacy that are essential to an equitable and efficient workers’ compensation system. Their annual conference gathers stakeholders from the areas of human resources, health and safety, risk management and claims. Medical professionals and service providers also attend. To learn more about this event, click here.
67th Annual Convention of the Southern Association of Workers’ Compensation Administrators
Conference Chronicles will be blogging from the 67th Annual Convention of the Southern Association of Workers’ Compensation Administrators (SAWCA) on July 20-24, 2015 in Colonial Williamsburg, VA. SAWCA was formed in 1949 and incorporated in 1980. The SAWCA membership includes 20 jurisdictions; 18 states, District of Colombia and the Virgin Islands. The States are: Alabama, Arkansas, Colorado, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia. For more information about this event, click here.