This week in comp, November 4, 2016

This week in comp is a weekly digest of workers’ compensation news from around the country.

Safety

OSHA plans surge of inspections to reduce amputations in Texas, neighboring states

Employers can follow a few simple tips to prepare for an OSHA inspection.

Employers can follow 10 tips to prepare for an OSHA inspection.

OSHA will leverage targeted enforcement, including a surge of on-site inspections, in its efforts to reduce amputations among manufacturing workers in Arkansas, Louisiana, Oklahoma and Texas…MORE

Texas leads nation in vehicle/animal collisions
Texas has twice as many motorists killed in collisions between vehicles and animals than any other state, the Insurance Council of Texas reports. With deer hunting season kicking off this weekend, drivers should review these safety tips…MORE

Opioid epidemic

Opioids and workers’ compensation: Why employers should care
Employees who abuse opioids risk their lives and compromise their co-workers’ safety. They could also contribute to increased workers’ compensation premiums. Studies cited in a Lockton Companies whitepaper have shown that when injured workers are prescribed opioids, their total claim costs can be four to eight times those of similar claims where no opioids were prescribed…MORE

More children are being poisoned by prescription opioids
The rate of children hospitalized for opioid poisoning increased 165 percent from 1997 to 2012, according to a new study. The data also showed the rate of hospitalized toddlers more than doubled. It’s likely that these very young patients take the drugs because they think they are candy or a treat…MORE

Fraud

Dallas-area doctor faces $1.2M fine in fraud scheme
Government officials have obtained a more than $1.2 million judgment against Dr. Tariq Mahmood of Cedar Hill. Mahmood is serving an 11-year sentence for submitting bogus Medicare and Medicaid claims…MORE

Underwriting

NCCI updates

Agents can bookmark Texas Mutual's website for the latest NCCI developments.

Texas Mutual encourages agents to bookmark our website for the latest NCCI developments.

TDI has posted notice of filing Item 02-TX-2016 by the National Council on Compensation Insurance (NCCI). NCCI’s filing proposes to establish eligibility requirements for wrap-up construction project policies. TDI also posted an order approving NCCI filing Item B-1431 to eliminate some Texas classifications with low credibility (classification codes that, due to low premium volume, are too small to develop meaningful data for ratemaking purposes) and reassign them to other national or Texas classifications.

Claims

Workers’ comp drug spend dips
Workers’ compensation payers’ pharmacy spend dipped 8.7 percent in 2015, according to a CompPharma survey. Payers credited tighter clinical management, better integration with their pharmacy benefit managers, and prescriber interventions for the decrease. Opioids remained the number-one payer concern…MORE

The best of the rest

What’s really happening in workers’ comp?
Injury rates are plummeting, insurance premium rates are flat or dropping, and medical costs are down, reports Joe Paduda of Managed Care Matters. Paduda adds that Texas and Louisiana experienced among the largest rate drops in the country…MORE

This week in comp, October 28, 2016

This week in comp is a weekly roundup of workers’ compensation news from across the country.

Safety

Hazard communication: SDS and secondary label compliance following the GHS deadline

OSHA requires employers to train their employees on the revised hazard communication standard.

OSHA requires employers to train their employees on the revised hazard communication standard.

Manufacturers and distributors are working to distribute GHS-compliant safety data sheets (SDS). In the meantime, employers should keep detailed documentation of their efforts to get SDS’ for their products…MORE

Age is more than a number
With more Americans putting off retirement, employers can take steps to help older workers remain healthy and productive…MORE

Claims

Why are work comp medical costs decreasing?
About 90 percent of the employed population has health insurance, a 10 percent increase over 2010. That means workers’ comp doesn’t have to pick up the tab for comorbidities and other non-work related conditions, which has led to a decrease in work comp medical costs…MORE

Claims has to up its game to attract new hires
With 25 percent of the claims workforce set to retire in the next few years, insurers are looking for new talent. In-house training and college partnerships are key strategies in filling the gap…MORE

Opioid epidemic

SAMHSA releases app to help treat opioid abusers

There are not enough doctors providing medically assisted treatment for opioid abuse, according to SAMSHA.

In 2015, nearly 2.4 million Americans had an opioid abuse disorder, according to SAMHSA.

The Substance Abuse and Mental Health Services Administration has released a smartphone app that provides essential resources and information to doctors interested in using medication-assisted treatment therapies to treat patients with a prescription opioid abuse disorder…MORE

Fraud

DWC fraud unit extends its reach
The new in-house fraud unit at the Division of Workers’ Compensation has opened more than 40 investigations and hired additional investigators to extend its reach. The unit exclusively focuses on investigating workers’ comp fraud in Texas…MORE

Racketeering charges detail scam to defraud workers’ comp fund
Prosecutors say between 2008 and 2014, a chain of medical clinics defrauded Ohio’s Bureau of Workers’ Compensation by billing for procedures that were never done and inflating the percentage of disability for injured workers, making them eligible for higher payments from the state…MORE

Deputy nabbed in alleged workers’ comp fraud: Heavy weights, squats, burpees?
A California deputy tripped over a fire hose and claimed he injured his back, left shoulder and left side of his neck during a boat rescue. Despite claiming he was unable to lift heavy objects, do squats or run, the deputy was seen doing box jumps, burpees, squats and other exercises, prosecutors allege…MORE

Cyber security

Cyber-attacks a ‘wake-up call’ for insurers and public

Hackers used millions of Internet of Things devices to launch a major cyber-attack last week.

Hackers used millions of Internet of Things devices to launch a major cyber-attack last week.

Last week, hackers attacked a company that facilitates the loading of web pages, shutting down Twitter, Amazon and other popular sites. A cyber security expert predicts that as individuals and businesses become more comfortable with internet-based and cloud-based storage, we make ourselves more vulnerable to future attacks…MORE

The best of the rest

Industry needs to address gaps in workers’ compensation, AMCOMP panelists say
Legal disparity from state-to-state and the lack of a common compliance standard has led to an increase in litigation and a lack of clarity around which workers’ compensation laws are considered constitutional, according to a panel discussion during the American Society of Workers’ Compensation Professionals fall meeting…

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This week in comp, October 21, 2016

This week in comp is a weekly digest of workers’ compensation news from around the country.

Safety

OSHA delays anti-retaliation component of electronic reporting rule
OSHA has delayed enforcement of the anti-retaliation component of its new electronic injury and illness reporting rule until Dec. 1, 2016. The component was schedule to go into effect November 10…MORE

Fall protection again tops list of most frequently cited OSHA standards

OSHA requires staffing agencies and host employers to share responsibility for keeping temporary workers safe.

Texas Mutual encourages employers to follow these 10 tips to survive an OSHA audit.

Fall protection tops the 2016 list of most frequently cited OSHA standards, followed by hazard communication and scaffolds. OSHA recommends employers who want to improve workplace safety use the list as a starting point…MORE

Does your medication affect your driving?
Few would argue that driving under the influence of alcohol, cocaine, marijuana and other street drugs is dangerous. But did you know over-the-counter and prescription drugs can also affect your ability to drive safely? The AAA Foundation launched a website that teaches you how your medications might affect you and your driving…MORE

7 common workplace violence prevention mistakes
Workplace violence policies should be written at an 8th grade level to accommodate all workers. Violence prevention training should be interactive, teaching employees to recognize threats and respond appropriately, according to the CEO of Violence Free…MORE

Underwriting

California, New Jersey register highest workers’ comp rates
Workers’ comp rates in California and New Jersey are 188 and 158 percent above the national median, respectively. North Dakota registers the lowest rates at 48 percent below the median, according to an Oregon Department of Consumer and Business Services report…MORE

Fraud

Your RX for health care fraud

Doctors, patients, employers and insurance carriers are among the stakeholders who can commit health care fraud.

Doctors, patients, employers and insurance carriers are among the stakeholders who can commit health care fraud.

The Coalition Against Insurance Fraud estimates health care fraud steals tens of billions across all lines of insurance annually. Employers can protect their business from fraud by following a few simple tips…MORE

Ten Texans added as defendants in
$100 million compounding drug scheme
A superseding indictment alleges that from approximately May 2014 to mid-February 2016, 12 defendants conspired to run a scheme to defraud TRICARE in connection with the prescription of compounded pain and scar creams. The scheme involved kickbacks to TRICARE beneficiaries, prescribing physicians and marketers by the owners of compounding pharmacies…MORE

Claims

New Texas ‘two-step’ program aims to simplify workers’ comp disputes
Under a new Texas Department of Insurance, Division of Workers’ Compensation program, hearing officers can decide the most far-reaching disputed claim issues first, clearing the way for secondary issues to be resolved sooner. Hearing officers will only use the two-step approach if both parties agree…MORE

Cyber security

Cyber claims continue to be costly

The average data breach costs $665,000.

The average claim payout for a data breach is $357,000, and insiders are involved in 30 percent of cases.

The average data breach claim for a large company is almost $6 million, according to a new study. While large companies continue to be targeted, the majority of claims are for organizations with less than $2 billion in revenue…MORE

Opioid epidemic

DEA cuts opioid production 25 percent
The Drug Enforcement Administration (DEA) has reduced by 25 percent the amount of almost every Schedule II opiate and opioid medication that may be manufactured in the United States in 2017. The DEA sets manufacturing quotas to ensure adequate supply for legitimate medical purposes while limiting the amount available for diversion. A recent study found that 6.5 million Americans used controlled substances for non-medical purposes during the past month…MORE

A look inside the workers’ comp market’s opioid problem
Opioids are costly and addictive, and research suggests they could exacerbate pain. Alternative therapies, such as occupational therapy, physical therapy and nerve blockers can be safer and more effective from a cost and treatment perspective…MORE

 

 

 

This Week in Comp, October 14, 2016

This Week in Comp is a weekly digest of workers’ compensation news from around the country.

Safety

5 tips to help prevent fires

The National Fire Protection Association encourages everyone to replace their smoke alarms every 10 years.

The National Fire Protection Association encourages everyone to replace their smoke alarms every 10 years.

In recognition of National Fire Prevention Week, follow these five tips for preventing workplace fires: Have a plan, train your staff, be careful with combustibles, keep it clean and safely store flammables…MORE

Study finds Ebola treatment ZMapp holds promise
A clinical trial to evaluate the experimental Ebola treatment ZMapp found it to be safe and well-tolerated. But because of the waning Ebola epidemic, the study enrolled too few people to determine definitively whether it is a better treatment for Ebola than the best available standard of care alone…MORE

Fraud

Medical ID theft continues to rise
Nearly 2.5 million medical identify theft cases were reported in 2014, an increase of 20 percent from the year before. A stolen medical identity can ruin your finances, compromise your medical treatment and cause you legal problems…MORE

Recycling company admits $600,000 premium fraud scheme

Employers who commit premium fraud get an unfair advantage over honest competitors.

Employers who commit premium fraud get an unfair advantage over honest competitors.

The owner of a New Jersey recycling company misclassified his employees and cheated his workers’ compensation carrier out of $600,000 in premiums. The man told his carrier that all but a handful of his employees did clerical work. An investigation revealed that most of the employees were warehouse workers doing higher-risk tasks…MORE

Medical costs

New report examines impact of reforms on medical costs
From 2010 to 2013, medical payments per claim increased 6 percent per year in Texas, double the rate in the median state. However, Texas medical costs per claim remain lower than the typical study state, according to a new Workers’ Compensation Research Institute report. The report examines how workers’ comp system reforms in 18 states have affected medical costs…MORE

Opioid epidemic

WCRI offering free webinar on latest opioid studies
Opioid abuse has touched every aspect of the health care system, including workers’ comp. On Thursday, October 20, the WCRI will host a free webinar based on its recent study examining the prevalence of longer-term use of opioids among injured workers in 25 states…MORE

Underwriting

U.S. workers’ compensation delivers underwriting profit despite rate deterioration 

Net written premiums in 2015 totaled $48.2 billion, second-highest level since $49.7 billion in 2006.

Net written premiums in 2015 totaled $48.2 billion, the second-highest level since $49.7 billion in 2006.

Premium growth, technological advancements, declining frequency trends and favorable levels of reserve development propelled the U.S. workers’ comp industry to a combined ratio of 96 in 2015, a 5.5 percent improvement over 2014, according to an A.M. Best report. Three of the four largest companies in the workers’ compensation composite, including Texas Mutual, are state funds and have accounted for over 20 percent of the composite’s overall premium volume…MORE

State fund news

NM Mutual starts work on new $17M headquarters
New Mexico Mutual broke ground this week on a 58,000-square-foot headquarters situated on five acres in Albuquerque. The new office will include common areas where employees can plug in their laptops and do short-term tasks…MORE

IVMS drives fleet safety
In-vehicle monitoring systems can help employers change the unsafe habits that drive traffic accidents. Read the third-quarter edition of the AASCIF newsletter for more information on IVMS, prescription drug monitoring programs and state funds’ contributions toward managing work injury risk…MORE

This week in comp, October 7, 2016

This week in comp is a weekly digest of workers’ compensation news from around the country.

Safety

Don’t delay – Get your flu shot before flu season strikes

Each flu season, Americans miss nearly 111 million workdays. That equals approximately $7 billion per year in sick days and lost productivity.

Each flu season, Americans miss nearly 111 million workdays. That equals to approximately $7 billion per year in sick days and lost productivity.

With flu season ramping up this month, health officials urge everyone over the age of 6 to get a flu shot. Flu vaccination is particularly important for pregnant women, young children, older adults and people with chronic health conditions…MORE

DSHS issues Zika alert to South Texas
The Texas Department of State Health Services (DSHS) considers South Texas to be at greater risk of supporting local mosquito transmission of Zika virus. This week, DSHS recommended health care providers test pregnant women residing in Cameron, Hidalgo, Starr, Webb, Willacy or Zapata counties who are experiencing two or more of the major signs and symptoms of Zika disease and have no travel history or sexual exposure…MORE

Dear drivers: Please use caution this fall
Collisions between drivers and animals increase 67 percent in the fall, according to a study. We should all follow a few simple tips to share the road safely with our fellow four-legged travelers…MORE

What’s your most important in-vehicle safety feature?
Traffic accidents are consistently the leading causes of workplace fatalities. Many fatalities could be avoided by following basic safe driving principles. During Drive Safely Work Week, safety experts urged employers to remind their employees that they are the most important safety feature when they get behind the wheel…MORE

Fraud

Contractor convicted in $5.4 million fraud scheme

Employers who commit premium fraud get an unfair advantage over honest competitors.

Employers who commit premium fraud get an unfair advantage over honest competitors.

A California contractor under-reported payroll and cheated his workers’ comp carrier out of $5.4 million in premiums. The contractor’s sentence includes 270 days in jail, five years’ probation, 1,500 hours of community service and restitution exceeding $5.4 million…MORE

Claims

2016 report card shows networks working as expected
When the Texas Legislature introduced health care networks into the workers’ compensation system in 2005, one of its goals was to improve injured worker outcomes. TDI’s 2016 report card shows networks are working as expected. Network claims produce higher return-to-work rates, fewer weeks off work and better physical functioning scores than non-network claims…MORE

Is grammar still important?
Remember the basics of grammar and punctuation you learned in school? Many of those rules are obsolete, thanks to the emergence of Twitter, text messaging and other digital communication. And that’s okay; communication evolves, and its governing principles must also evolve. But sometimes, poor grammar results in litigated or overpaid claims…MORE

Cybersecurity

Hackers target small businesses

Approximately 64 percent of businesses have experience more than six hacking incidents in the past year.

Approximately 64 percent of businesses have experienced more than six hacking incidents in the past year.

Approximately 90 percent of businesses reported at least one data breach during the past year. Because many big businesses have beefed up their cyber defenses, small businesses make attractive targets for hackers. Risk managers should identify data that hackers might find valuable, prioritize what data to protect and decide how to maximize their resources…MORE

Opioid epidemic

New workers’ comp opioid prescribing rule takes effect in Ohio
Under a new Ohio law, the Bureau of Workers’ Compensation (BWC) only reimburses for opioid prescriptions when the physician followed best prescribing practices. The BWC also provides treatment for dependence that arises from the use of opioid medications covered by BWC…MORE

The best of the rest

TDI tops list of 20 most helpful state insurance websites
Update-to-date rate comparisons, comprehensive complaint information and prompt customer service propelled the Texas Department of Insurance website to the top in a recent evaluation of state insurance websites…MORE

AIA responds to DOL workers’ comp system report
The nation’s state-based workers’ compensation system is grounded in the economies of the individual states. The system is, therefore, sensitive to those changing economies, as well as to system imbalances. That was the American Insurance Association’s response to the Department of Labor’s State Workers’ Compensation Report…MORE

This week in comp, September 30, 2016

This week in comp is a weekly digest of workers’ compensation news from across the country.

Safety

old_guy_white

Older workers suffer fewer injuries, but they take longer to recover when they do get injured.

National Employ Older Workers Week is a chance to reflect on the safety and health needs of older workers
The number of people aged 55 years and older in the workforce grew from 15.5 million in 1994, to 23 million in 2004 to 33.9 million in 2014. Experts expect the number to hit 40.6 million by 2024. During National Employ Older Workers Week, the Department of Labor offered tips to help employers protect today’s multigenerational workforce from on-the-job injuries…MORE

OSHA increases scrutiny of whistleblower settlement agreements
OSHA announced new policy guidelines that provide enhanced scrutiny for whistleblower settlement terms that it views as restricting an individual’s right to engage in a protected activity, such as filing a complaint with a government agency, participating in a government investigation, or receiving an award under a government-sponsored whistleblower award program…MORE

Fraud

Interpreters sentenced in workers’ comp billing scam
A husband and wife who owned and operated a foreign-language interpreter firm have been sentenced to 90 days in jail for a fraudulent billing scheme. The firm’s interpreters accompanied Spanish-speaking workers’ comp claimants on doctors’ appointments. An investigation found that the couple billed for interpretive services where no medical providers submitted a bill, padded bills for services that were provided, and submitted bills for uncertified interpreters…MORE

Claims

New study explores claim trends among health care workers

OSHA is working to reverse the tend in workplace violence and strains/sprains among health care workers.

OSHA is working to reverse the tend in workplace violence and strains/sprains among health care workers.

A new study found that the severity of workers’ compensation claims in the health care industry has been increasing at a rate of 2 percent annually, but claim frequency is expected to decrease 1 percent annually. The report also speculated loss costs will increase 1 percent during the 2017 accident year…MORE

Texas Department of Insurance sets weekly benefit rates
The Texas Department of Insurance (TDI) has set the state average weekly wage for dates of injury from Oct. 1, 2016, through Sept. 30, 2017, at $912.69. TDI set the maximum weekly benefit rates for workers’ compensation income benefits at $913 and the minimum weekly benefit rate at $137 for that period.…MORE

Legislation

Comp world has eyes on ColoradoCare
Colorado’s Amendment 69, also known as ColoradoCare, would create a single-payer system for health care, including the care delivered to injured workers through the workers’ comp system. Amendment 69 proponents posit that ColoradoCare will better protect employers’ and injured workers’ interests. Opponents, including Colorado’s state-chartered workers’ compensation provider, stress that the workers’ compensation system is fundamentally a return-to-work system, not a health care system…MORE

Opioids

Employers’ role in reversing the opioid epidemic

A recent study found that one out of every three opioid prescriptions is being abused.

A recent study found that one out of every three opioid prescriptions is being abused.

Opioid abuse costs employers about $52 million per year in terms of lost productivity and health insurance. By addressing prescription medication abuse in their workplace drug policies, employers can help control the human and monetary costs of the opioid epidemic…MORE

Nation’s top painkiller prescriber charged with drug diversion
Federal prosecutors charged a former physician, who was the nation’s highest Medicare prescriber of opioid painkillers at the height of his practice, with illegally prescribing controlled substances and with health care fraud involving $9.5 million in unneeded and unused urine tests…MORE

Medical costs

What Medicare’s reimbursement changes mean for work comp
Congress’ new Medicare fee schedule will increase reimbursement 0.5% per year until 2019. The new schedule will affect workers’ compensation in the form of continued increases in reimbursement for cognitive services, office visits, physical therapy and similar services, according to Joe Paduda of Managed Care Matters…MORE

 

This week in comp, September 23, 2016

This week in comp is a weekly digest of workers’ compensation news from across the country.

Texas Mutual news

richard-gergasko-9908_750xx3000-1691-0-263

Rich Gergasko has served as Texas Mutual president and CEO since 2013.

2016 Best CEOs: Rich Gergasko, Texas Mutual
Texas Mutual President and CEO Rich Gergasko was named among the best CEOs of 2016 by the Austin Business Journal…MORE

10 tips for surviving an OSHA inspection
OSHA increased its fee structure by 80 percent in August. This week’s blog post featured 10 tips employers can follow to stay off OSHA’s radar and survive an audit if an inspector comes knocking…MORE

VR safety tool earns innovation award

Texas Muutal's Jeremiah Bentley accepts an innovation award for the company's virtual reality safety training tool, Safety in a Box.

Texas Muutal’s Jeremiah Bentley accepts an innovation award for the company’s virtual reality safety training tool, Safety in a Box.

Texas Mutual earned an SMA Innovation in Action Award for its Safety in a Box virtual reality training tool. The award spotlights insurers and solution providers who completed transformational projects or initiatives in the past year…MORE
Safety

Zika update
As of Friday, September 23, Texas has recorded 201 cases of Zika virus, with Harris County accounting for 56 of those cases. All cases were associated with travel to an area where Zika is being spread…MORE

Top 5 ergonomic trends redefining the workplace
Everyone wants to be Google. The trendy tech company is redefining corporate culture with its free gourmet meals, massages and nap pods. It’s also redefining workspaces by making them fit their employees’ bodies…MORE

Opioid epidemic

Opioid epidemic costs U.S. $78.5 billion annually: CDC
Abuse of powerful prescription painkillers called opioids costs the U.S. economy $78.5 billion a year in lost productivity, direct health care costs and costs to the criminal justice system, according to a new study from the Centers for Disease Control and Prevention. Medicaid, Medicare and other public programs shoulder nearly 25 percent of the costs…MORE

Jury convicts pill mill doctor

The opioid epidemic claims 78 American lives every day, according to the Centers for Disease Control and Prevention.

The opioid epidemic claims 78 American lives every day.

A California doctor faces 13 years in prison for unlawfully prescribing controlled substances without a legitimate medical need to undercover operatives working with the Drug Enforcement Administration…MORE

Technology

Why insurers must pick up their technology pace
Nowadays, insureds are just as likely to compare a carrier’s service responsiveness to that of companies such as Amazon as they are to compare them to another carrier’s responsiveness. That means insurers must adopt technology to streamline their operations…MORE

Claims

Pilates Ball

Workplace wellness programs can help reduce operating costs and improve productivity.

Overweight and obesity linked to high workers’ comp costs for major injuries
In a new study of major-injury claims, costs for obese workers averaged about $470,000, and costs for overweight workers averaged $270,000. That compares with average costs of $180,000 for normal-weight workers. The study underscores the importance of workplace wellness programsMORE

State fund news

Beacon Mutual automates medical-only claim process
Information technology and claims professionals at Beacon Mutual put their heads together to streamline the medical-only claims process. The organization’s new medical-only auto-adjudication tool files medical-only claims and issues payments without human intervention…MORE

New Mexico Mutual empowers underwriters with predictive technology
New Mexico Mutual has partnered with Valen Analytics to give underwriters increased visibility into risks and set consistent prices with a new predictive analytics tool…

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