CMS change in Part D Manual suggests increased MSP enforcement
The Centers for Medicare and Medicaid Services (CMS) has amended its Medicare Prescription Drug Benefit Manual (Part D) to add stronger language regarding Medicare Part D sponsors’ secondary payer rights and recovery. A claim for a drug that should be paid as MSP may not be submitted or paid as a primary claim by the Medicare plan. It’s expected that Part D plans will more aggressively assert their secondary payer status, either through coverage denial and/or increased Part D recovery claims regarding workers’ compensation, liability, and other non-group health claims.
NIOSH releases silica monitoring software
NIOSH has unveiled a beta version of an online software tool designed to provide post-shift assessments of mine worker exposure to respirable crystalline silica. The Field Analysis of Silica Tool uses portable infrared technology to analyze exposure to crystalline silica.
New CSB ‘Safety Digest’ and video spotlight winterization safety at chemical, processing facilities
Safety challenges posed by cold weather at refineries, chemical plants and other facilities that handle hazardous materials are addressed in a new Safety Digest and corresponding video from the Chemical Safety Board.
NORA Manufacturing Council unveils website to help with lockout, other energy control programs
The National Occupational Research Agenda Manufacturing Sector Council has created an online resource guide intended to assist organizations in beginning, maintaining or enhancing their hazardous energy control programs.
New for nurses: Online continuing education on preventing MSDs
The Center for the Promotion of Health in the New England Workplace introduced a free online continuing education program intended to help nurses prevent musculoskeletal injuries during clinical care. Ergonomics in Healthcare includes learning modules, case studies, videos, reference materials and guidelines for reducing injuries incurred while treating patients.
FMCSA releases final rule lifting exemptions for truck drivers with diabetes
The Federal Motor Carrier Safety Administration has issued a final rule intended to ease restrictions on commercial motor vehicle drivers whose insulin-treated diabetes mellitus is under control, according to a notice in the Sept. 19 Federal Register. The rule is scheduled to go into effect Nov. 19.
New resources for the construction industry from CPWR
CPWR – The Center for Construction Research and Training (CPWR), a recently launched six new safety resources:
- A training program on noise hazards and preventing hearing loss, and a training module on effective safety leadership for construction foremen and team leaders.
- Online tools to help prevent injuries from manually lifting and moving heavy materials, and conducting Safety Climate Assessments to improve worker safety perceptions at jobsites.
- A list of personal protective equipment designed for female construction workers.
- An online network of construction safety and health experts and resources.
National Safety Council enhances Injury Facts website
The National Safety Council has enhanced the workplace section of its online “Injury Facts” database to help employers better understand the injury rates in their industries and to improve safety measures. Employers can plug in information, such as industry and tasks, to calculate risks, and obtain data on fatality rates and fatigue.
State-by-state map of opioid abuse
FAIR Health, an independent nonprofit that collects data and maintains the country’s largest database of privately billed health insurance claims, published a new white paper on opioid abuse and dependence related to regional and state differences in treatment. It includes a “heat map” to show which areas have higher opioid abuse and dependence claim lines as a percentage of total medical claim lines in 2017.
State News
California
- Cumulative trauma claim rates have grown by 50% since 2008 and 40% of such claims are filed after an employee is terminated, according to a report by the Workers Compensation Insurance Rating Bureau
- Medical payments per claim in 2017 decreased, averaging between $5,000 and $10,000 according to the Workers Compensation Research Institute (WCRI)
- Became the first state to require professional cosmetics manufacturers to disclose ingredients – including hazardous chemicals – on their product labels
Indiana
- The Department of Insurance has approved a 5.6% loss-cost reduction and an overall rate level decrease of 7.6%, which will take effect Jan. 1
- Was one of the three states with the highest medical payments per claim in 2017, averaging just below $20,000, in a study of 18 states by WCRI
Michigan
- The pure premium advisory rate will decrease by 8.3% in 2019, marking the eighth consecutive rate decrease says the Department of Licensing and Regulatory Affairs
- Medical payments per claim averaged between $5,000 and $10,000 in 2017 according to WCRI
New York
- Surpassed California as having the highest workers’ compensation costs in the country, according to the Oregon Department of Consumer and Business Service
North Carolina
- The Insurance Commissioner has approved an average 17.2% decrease in workers’ compensation rates, effective April 1, 2019. For industry groups, the rating bureau’s proposed decrease were an average: 15.8% for manufacturing industry groups, 6.5% decrease for contracting, and 19.3% decrease for the office-clerical and goods-services industries
- Starting Nov. 1, health care providers must check the state’s prescription drug monitoring system before prescribing a controlled substance to an injured worker
- Decreases in medical payments per claim in 2017 were the steepest of eighteen states studied by the WCRI at 6% per year
Pennsylvania
- Gov. Tom Wolf signed into law a bill that reinstates impairment ratings. Under the new law, an employer can request an impairment evaluation where a physician determines the degree of an injured employee’s impairment under the Pennsylvania Workers Compensation Act after the employee was injured for 104 weeks. Doctors are to refer to the “most recent” edition of the American Medical Association’s Guide to the Evaluation of Permanent Impairment
- Faster-than-typical growth in medical payments per claim was driven by faster growth in hospital outpatient payments per claim according to the WCRI
Tennessee
- The Workers’ Compensation Advisory Council recommended a 14% decrease in the rate for the voluntary and assigned risk market, rather than the 19.1% recommended by NCCI
Virginia
- Was one of the three states with the highest medical payments per claim in 2017, averaging just below $20,000, in a study of 18 states by WCRI
Wisconsin
- In contrast to moderate-to-rapid growth in prior years, the state experienced little growth in medical payments per claim since 2014 according to the WCRI
- Was one of the three states with the highest medical payments per claim in 2017, averaging just below $20,000, in a study of 18 states by WCRI
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