Oakland, CA – The Workers’ Compensation Insurance Rating Bureau of California (WCIRB) recently released a new study, Physical Medicine Treatments and Their Impact on Opioid Use and Lost Time in California Workers’ Compensation. The study reveals insights into the overall trends and patterns of physical medicine treatment cost and utilization. It quantifies the potential substitution… [Read more]
Claims, Legal, & Compliance News
Helmsman Management Services Closes Acquisition of TPA Eberle Vivian
Boston, MA – Helmsman Management Services (HMS), Liberty Mutual’s wholly owned third-party administrator, has announced the close of its previously announced deal to acquire Eberle Vivian Inc., a well-respected regional third-party administrator (TPA) serving the Pacific Northwest. “The acquisition – and the continuation of the strong Eberle Vivian brand as an operating unit within Helmsman… [Read more]
Guest Post: Three Ways Workers’ Compensation Insurers Can Reduce Opioid Addiction
By Dwight Robertson, M.D., Medical Director, EMPLOYERS The U.S. opioid crisis has riddled news headlines, impacted healthcare policy, influenced political debate and discourse, and affected thousands of lives across the country. Every day, more than 130 people die from an opioid overdose. Opioids are among the most commonly prescribed painkillers for injuries covered by workers’… [Read more]
TDI-DWC: Medical Facility Convicted of Workers’ Compensation Fraud
Austin, TX – A Houston medical facility recently pled guilty in a Travis County District Court to workers’ compensation fraud and was ordered to pay $30,000 in restitution. EME International, owned by Christine Caldwell of Marblehead, MA was convicted of a 3rd degree felony. Her facility billed Texas Mutual Insurance for two to four-hour Functional… [Read more]
2019 WC Benchmark Study Report Compares Claims Leader & Frontline Staff Perspectives
Chicago, IL – With an estimated 140.3 million U.S. workers receiving workers’ compensation benefits, frontline claims professionals are personally responsible for managing a total economic outlay of nearly $100 billion dollars in benefits paid annually. Coupled with the industry’s talent crisis – with an imminent mass exodus of retiring claims professionals and challenges attracting young… [Read more]
Mitchell | Genex Announces Acquisition of CompAlliance
San Diego, CA – Mitchell | Genex, a leader in technology solutions, medical cost containment, and disability management has announced its acquisition of CompAlliance, an established provider of managed care services, including its Preferred Provider Organization (PPO), Medical Bill Review, Case Management, Utilization Review, and 24-hour Nurse Triage. Financial Terms were not disclosed. With this… [Read more]
Judge Sentences TX Businessman to Federal Prison for Health Care Fraud Scheme
San Antonio, TX – A federal judge recently sentenced San Antonio businessman Rafael Enrique Rodriguez to seven (7) years in federal prison for his role in a multi-million-dollar health care fraud scheme. In addition to the prison term, Senior U.S. District Judge David A. Ezra ordered that Rodriguez pay $6,032,126.69 in restitution to the government… [Read more]
Safety National Webinar: You Have Predictive Analytics – Now What?
St. Louis, MO – Safety National recently announced a new complimentary webinar, noting that predictive analytics have quickly become a necessary tool for effectively managing workers’ compensation programs, however, they do not produce cost savings on their own. They are merely a first step to a larger workers’ compensation claims management strategy. In the webinar… [Read more]
Ametros Establishes Regulatory Advisory Council
Wilmington, MA -(BusinessWire)- Ametros recently announced that it has established an expert Regulatory Advisory Council led by the company’s Senior Managing Director, Paul Sighinolfi, and chaired by its CFO, Nicole Sauk. The Council monitors and analyzes proposed changes to the Medicare Secondary Payer statute, workers’ compensation rules, and healthcare regulations. Given the important interaction that… [Read more]
CA DWC Posts Reminder for Submission of Annual Report of Inventory for 2019 Claims
San Francisco, CA – The California Division of Workers’ Compensation recently issued a reminder to claims administrators that the annual report of inventory (ARI) must be submitted in early 2020 for claims reported in calendar year 2019. The California Code of Regulations, title 8, Section 10104 requires claims administrators to file, by April 1 of… [Read more]