San Francisco, CA – The Division of Workers’ Compensation (DWC) has issued a notice of public hearing for proposed evidence-based updates to the Medical Treatment Utilization Schedule (MTUS), which can be found at California Code of Regulations, title 8, sections 9792.22 and 9792.24.5. The public hearing is scheduled for Wednesday, July 18 at 10 a.m. in the auditorium of the Elihu Harris Building, 1515 Clay Street, Oakland. Members of the public may review and comment on the proposed updates…[Continue Reading]
Workers' Compensation
MS Nurse Practitioner Pleads Guilty in $1.3 Million Compounding Pharmacy Fraud Scheme
Jackson, MS – A Mississippi-based nurse practitioner recently pleaded guilty for her role in a scheme to defraud health care benefit programs including TRICARE, the health care benefit program serving U.S. military, veterans and their respective family members. Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, U.S. Attorney D. Michael Hurst Jr. of the Southern District of Mississippi, Special Agent in Charge Christopher Freeze of the FBI’s Jackson, Mississippi…[Continue Reading]
Medcor Announces Acquisition of TalisPoint
McHenry, IL – Chicago-based Medcor, Inc., the leading health navigation firm, has acquired San Francisco-based Talisman Systems Group, Inc., the leading provider of network management services for workers’ compensation and other industries. Talisman will operate as an independent subsidiary of Medcor, retaining its leadership and TalisPoint brand and will remain based in San Francisco. Medcor navigates patients to optimal care through onsite clinics and virtual health services, using evidence-based…[Continue Reading]
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]
WA Lifesaving Awards Honor Workplace Heroes – Nominations Open Now
Tumwater, A – Many people spend nearly as much time at work as they do at home, so when a life-threatening emergency happens, it’s often other workers who must provide critical, immediate aid. That quick action can be the difference between life or death. The Governor’s Industrial Safety and Health Advisory Board presents awards to workplace heroes at its annual conference, and now’s the time to nominate people for the 2018 Governor’s Lifesaving Awards. There are several workplace lifesavers in…[Continue Reading]
John Elias Begins Term as New Hampshire Insurance Commissioner
Concord, NH – John Elias recently began his five year term as Commissioner of the New Hampshire Insurance Department. He was nominated by Governor Chris T. Sununu and unanimously approved by the New Hampshire Executive Council in May. “I am honored to be trusted with this responsibility,” said Commissioner John Elias. “I am excited to get started working in this new role on behalf of New Hampshire.” Elias’s priorities as commissioner include regulatory modernization, operational efficiency…[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]
MEMIC Honors Eight Employers for Outstanding Workplace Safety
Portland, ME – At its Annual Meeting of the Policyholders last week, workers’ compensation specialist The MEMIC Group presented awards for workplace safety to eight of its more than 21,000 policyholders. MEMIC Senior Vice President of Loss Control and Safety Services Karl Siegfried paid tribute to the following employers for their workplace safety efforts at the Portland Museum of Art. Buffalo Games, LLC is the premier manufacturing facility for jigsaw puzzles and party games in North America, selling more…[Continue Reading]
Ohio BWC Gets Eight Workers’ Comp Fraud Related Convictions in May
Columbus, OH – The eight Ohioans who pleaded guilty and no contest in May to fraud-related charges against the Ohio Bureau of Workers’ Compensation (BWC) include a homicide suspect, a Cincinnati bus driver who collected disability benefits while working two other jobs, and a health care provider who billed BWC for work his company didn’t perform. “Our convictions in May illustrate a range of fraud types that we see at BWC, some more serious than others,” said Jim Wernecke, director…[Continue Reading]
CWCI: CA Workers’ Comp IMR Volume & Outcomes Held Steady In Q1 2018
Oakland, CA – Data on California workers’ compensation independent medical review (IMR) decisions issued in the first quarter of this year shows that the medical dispute resolution process established as part of the 2012 workers’ comp reforms continues to produce consistent outcomes, with little change in the number of IMR determination letters and decisions; the percentage of modified or denied treatment requests that are upheld; the types of treatment requests reviewed; and the small number of…[Continue Reading]