By Colleen F. Slyngstad, Head of Customer Experience, CLARA analytics Over the past several years, attorney involvement in workers’ compensation claims has escalated dramatically. In fact, a Workers Compensation Research Institute (WCRI) study released last year showed that lawyers were involved in more than 50 percent of claims in New Jersey in cases where employees… [Read more]
Claims, Legal, & Compliance News
Ametros Publishes White Paper on Combination of Structured Settlements & Professional Administration
Wilmington, MA – Settling a workers’ compensation or liability claim can be daunting, especially for an injured party who needs ongoing medical care throughout their lifetime. While the settlement amount allocated or included in a Medicare Set Aside (MSA) may seem more than adequate to cover the injured party’s healthcare expenses, how can they guarantee… [Read more]
LA Workers’ Compensation, Appellate Court judges Find Common Ground at Inaugural Judicial Conference
Baton Rouge, LA – Several of Louisiana’s preeminent legal authorities recently convened at the Louisiana Supreme Court, at the invitation of Honorable Bernette Johnson, Chief Justice, for a series of in-depth discussions highlighting the distinct challenges faced by appellate court judges and workers’ compensation judges when reviewing and adjudicating cases, respectively. Judge Sheral Kellar, Assistant… [Read more]
WCRI Study Compares Hospital Outpatient Payments Across 35 States
Cambridge, MA – Hospital outpatient payments were higher and growing faster in states with percent-of-charge-based fee regulations or no fee schedules, finds a study from the Workers Compensation Research Institute (WCRI). The study is an annual series comparing hospital payments for a group of common outpatient surgeries in workers’ compensation across 35 states from 2005… [Read more]
WA L&I Crackdown on Illegal contractors Finds Nearly 50 Violators
Tumwater, WA – Surprise sweeps for unregistered contractors in Washington this month resulted in nearly 50 citations in three days. Inspectors with the Washington State Department of Labor & Industries (L&I) discovered the violations during unannounced visits to 636 construction sites throughout the state from June 12 to 14. L&I inspectors conducted the contractor compliance… [Read more]
NAMSAP Officers Discuss Opioids and MSAs at National Council of Self-Insurers Conference
Baton Rouge, LA – Over 20,000 Medicare Set-Asides (MSAs) are submitted to the Centers for Medicare and Medicaid Services (CMS) every year. A recent California Workers’ Compensation Institute study showed that 69.4 percent of the MSAs it reviewed allocated funds for opioids, despite evidence-based guidelines that indicate that opioids are not appropriate for long-term use… [Read more]
Court Denies Failed WC Insurer’s Use of CA Special Deposit Funds for Administrative Expenses
Sacramento, CA – In a case against Lumbermens Mutual Casualty Company, the Appellate Court of Illinois issued its decision supporting Insurance Commissioner Dave Jones and the California Insurance Guarantee Association’s (CIGA), position requiring Lumbermens California workers’ compensation deposits may not be used to reimburse overhead and administrative expenses incurred in connection with the company’s liquidation,… [Read more]
Rising Medical Solutions Extends Payer Tech Hub with Enhanced ODG Analytics
Chicago, IL – Rising Medical Solutions recently announced that it is now rolling out MCG’s powerful Official Disability Guidelines™ (ODG) analytics directly to customer users. Rising’s latest enhancement to its client web portal, VISION™, provides users with single sign-on access to ODG’s robust claims scoring capabilities, enabling claims professionals to more accurately and efficiently evaluate, mitigate, and manage risk. Augmenting Rising’s internal practice of applying ODG and other…[Continue Reading]
SUNZ Holdings Launches Expanded Subrogation Services
Bradenton, FL – SUNZ Holdings, LLC recently announced the formation of Avalon Subrogation Partners, LLC (“Avalon”), a subrogation company focused on recovering claim payments from parties who may have caused or contributed to the accident or insured the loss. Steven F. Herrig, Chief Executive Officer of SUNZ Holdings, said, “As a provider of large deductible workers’ compensation insurance solutions, our clients bear a substantial portion of workers’ compensation claims exposure…[Continue Reading]
Mitchell Releases Second Quarter 2018 Industry Trends Report
San Diego, CA – Mitchell recently released its Industry Trends Report (ITR) for the second quarter of 2018. The report includes a deep dive into how data analytics are now embedded into most levels of insurance organizations, presenting both challenges and opportunities. It also includes an exploration of how utilization review and precertification can help reduce unnecessary medical expenses—while also providing strong medical options for recovery. As technology becomes more deeply integrated into…[Continue Reading]