December 16, 2017

Mike Lundberg Joins CareWorks MCS as Head of Sales

Franklin, TN – CareWorks Managed Care Services recently announced that Mike Lundberg has joined the company as Managing Vice President. In this role, Mike will oversee the company’s sales and client development activities. “CareWorks MCS leverages technology, analytics and expertise to create custom solutions that deliver cost savings to clients and the appropriate care to injured workers. Mike’s proven track record leading successful sales teams in the managed care space…[Continue Reading]

CA DWC Suspends 21 Medical Providers for Fraud

San Francisco, CA – The Division of Workers’ Compensation (DWC) recently announced that it has suspended 21 more medical providers from participating in California’s workers’ compensation system, bringing the total number of providers suspended this year to 115. The providers were suspended for fraud or other criminal actions. DWC Administrative Director George Parisotto issued suspension orders against the following providers: The following providers participated in an illegal…[Continue Reading]

MT Workplace Injury and Illness Rates Decline for Fourth Straight Year

Helena, MT – For the fourth straight year, Montana’s workplace safety has improved, while injury and illness rates have declined. The annual Survey of Occupational Injuries and Illnesses conducted by the Department of Labor & Industry’s Data Management Unit showed that private industry workplaces in Montana have reported an incidence rate of 4.2 injury and illness cases per hundred full-time workers in 2016. The 2015 incidence rate was 4.3 cases per hundred full-time workers…[Continue Reading]

OSHA Extends Compliance Date for Electronically Submitting Injury, Illness Reports to December 15

Washington, DC – To allow affected employers additional time to become familiar with a new electronic reporting system launched on August 1, 2017, the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has extended the date by which employers must electronically report injury and illness data through the Injury Tracking Application (ITA) to December 15, 2017. OSHA’s final rule to Improve Tracking of Workplace Injuries and Illnesses sets…[Continue Reading]

TX Pharmacy Owner Pleads Guilty in Connection with Health Insurance Fraud Scheme

McAllen, TX – The 45-year-old owner of Penitas Family Pharmacy has pleaded guilty in connection with a scheme to defraud Blue Cross Blue Shield of Texas, announced Acting U.S. Attorney Abe Martinez. Omar Espericueta, of Palmhurst, pleaded guilty joining co-defendant Oscar Elizondo, 47, of Pharr, who pleaded guilty recently. Both men conspired to submit more than $1.7 million in fraudulent claims through Penitas Family Pharmacy aka Riverside Pharmacy to Blue Cross…[Continue Reading]

2017 Workers’ Comp Benchmarking Study Releases Three-Year Industry Report Card for Claims Best Practices

Chicago, IL – Now in its fifth year, the 2017 Workers’ Compensation Benchmarking Study reprises its 2014 survey questions to measure industrywide advancement in claims management these past three years. The study also continues its potent method of validating how and what higher performers are doing differently than lower performing peers to reveal a more robust profile of the successful claims organization. Findings from the just published 2017 study reflect the responses of 572 claims leaders…[Continue Reading]

Texas Mutual Distributes $3 Million in Early Qualifier Dividends to 4,000 Texas Businesses

Austin, TX – Texas Mutual Insurance Company recently paid more than $3 million in early qualifier dividends to approximately 4,000 newer policyholder owners across the state. This payout is the final component of the company’s $260 million record dividend distribution in 2017. Early qualifier dividend recipients are those who are already maintaining safe workplaces but haven’t been with Texas Mutual long enough to qualify for a regular dividend. It includes those who have a good loss…[Continue Reading]

CWCI: CA DIR Announces 2018 Workers’ Comp User Funding Assessment Rates

Oakland, CA – The California Department of Industrial Relations (DIR) has issued the 2018 assessments that workers’ compensation insurers are required to collect from policyholders to cover the budget of the state Division of Workers’ Compensation (DWC) and five related programs set up by state lawmakers. Insurers should apply the following rates against their policyholders’ estimated annual assessable premium for policies incepting January 1, 2018 through December 31, 2018…[Continue Reading]

Ohio Convict Adds Workers’ Comp Fraud to Criminal Record

Columbus, OH – A Cleveland garbage hauler and construction worker serving time in a federal prison for fraud, money laundering and violating the Clean Air Act pleaded guilty to workers’ compensation fraud last week. Christopher Gattarello, 53, pleaded guilty Nov. 22 to a fifth-degree felony count of workers’ compensation fraud for working while receiving temporary disability benefits from the Ohio Bureau of Workers’ Compensation. A judge in the Franklin County Court of Common Pleas sentenced…[Continue Reading]

WCRI: WI Medical Payments per Claim Higher Than Typical; Growth Slowing, but Still Faster Than Most Study States

Cambridge, MA – A new study by the Workers Compensation Research Institute (WCRI) found that Wisconsin’s medical payments per workers’ compensation claim were higher than typical for 2015 injuries evaluated as of March 2016. While growth in Wisconsin’s workers’ compensation medical payments per claim slowed in the past several years, medical payments were still increasing at a faster rate than other states that WCRI studied. The study, CompScope™ Medical Benchmarks[Continue Reading]

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