Things you should know

Rating agency reports fifth year of comp profits but forewarns profits are not sustainable

According to Fitch Ratings Inc, the workers’ compensation market is on track for a fifth consecutive year of underwriting profits in 2019, despite recent weakening in market fundamentals. The industry’s statutory combined ratio fell to 86% in 2018, and has averaged 93% annually since 2015, according to the report. However, the report notes several factors that could result in a sudden deterioration in performance including an increase in claims frequency or severity, and new regulatory developments in key states, according to the statement.

NIOSH issues new banding guide for chemicals in the workplace

NIOSH has published a technical report intended to help control chemical exposures in the workplace. The NIOSH Occupational Exposure Banding Process for Chemical Risk Management details a strategy for managing the many chemical substances that don’t have an authoritative occupational exposure limit. Occupational exposure banding is a process that assigns each chemical to a category based on its toxicity and any negative health outcomes associated with exposure to it.

FMCSA seeks to delay two provisions in final rule on CMV driver minimum training

The Federal Motor Carrier Safety Administration is requesting delaying compliance of two provision, which were scheduled to go into effect Feb. 7, 2020. These include requiring training providers to upload certification information into FMCSA’s Training Provider Registry and a provision for state driver licensing agencies to “receive driver-specific [entry-level driver training] information.”

Comments are due Aug. 19.

Another court decision favors MAO right to sue under private cause of action provision

Medicare Advantage Organizations (MAOs) received a favorable ruling on a motion to dismiss the case, MSP Recovery Series, LLC v. Plymouth Rock, in Federal Court in Boston. Since 2012 no court has concluded that MAOs do not have at least some rights under the private cause of action provision.

Study finds adherence to evidenced-based medicine guidelines for lower back pain lowers comp costs

recent study in the Journal of Occupational and Environmental Medicine concluded there is a statistically significant trend in the relationship between adherence to ACOEM guidelines for the initial management of work-related lower back pain and decreasing claim costs. Medical and total costs trended lower by an average $352.90 and $586.20 per unit of compliance score respectively. No outlier cost claims were in the best guidelines compliance groups.

CMS proposed decision to cover acupuncture

The Centers for Medicare & Medicaid Services (CMS) issued a proposed decision to cover acupuncture for Medicare patients with chronic low back pain (cLBP) who are enrolled participants either in clinical trials sponsored by the National Institutes of Health (NIH) or in CMS-approved studies. Currently, acupuncture is not covered by Medicare. The goal of the proposed decision is to provide Medicare patients who suffer from cLBP with access to a nonpharmacologic treatment option and to determine the effectiveness.

NAHB offers resources on managing opioid misuse in residential construction

In response to the particularly heavy impact the opioid crisis is having on the construction industry, the National Association of Home Builders has introduced several free resources intended to help residential construction organizations combat the issue.

These include:

  • An executive training package, including a webinar and other downloadable materials, outlining why industry action is needed
  • Supervisor training packages on workplace interventions and preventing opioid misuse in the industry
  • Fact sheets on the risks associated with taking opioids, and identifying medical and nonmedical opioid
  • Resources on non-opioid alternatives to pain management
  • A state-by-state guide of locally available resources

Study identifies what professions have worst drivers

study of 1.6 million car insurance applications by Cambridge, Massachusetts-based Insurify Insurance Co., an auto insurance comparison website, found that bartenders, ticket sales representatives, and journalists had the most moving violations. The cause? These professions tend to work 55-60 hours per week and sometimes work weekends. In contrast, postmasters and music composers are the best.

Helping employees get more sleep improves productivity: review of research

Basic employer interventions such as educating workers about the importance of sleep and sharing strategies to improve it may result in better sleep habits, increased productivity, and reduced absenteeism, a recent review of research concludes. The studywas published in the April 15 issue of the Journal of Clinical Sleep Medicine.

New video for tower workers explores safe installation, maintenance of small cell antennas

new two-and-a-half-minute video from the National Association of Tower Erectors stresses hazard awareness for technicians who work with small cellular antenna towers on new or existing structures.

State News

California

  • The Workers’ Compensation Insurance Rating Bureau (WCIRB) released its 2019 State of the System report highlighting key metrics of the state’s workers’ compensation system.
  • The Division of Workers’ Compensation posted an order updating the Medical Treatment Utilization Schedule. Treating providers, qualified medical evaluators and agreed medical evaluators, and utilization review and independent medical review physicians can access the MTUS guidelines at no cost by registering for an account here.

Florida

  • The Division of Workers’ Compensation has finalized a rule that defines which injuries “shock the conscience,” as required by legislation passed more than a year ago. The eight injuries deemed to be shocking to the conscience are:
    • Decapitation (full or partial).
    • Degloving.
    • Enucleation.
    • Evisceration.
    • Exposure of the brain, heart, intestines, kidneys, liver or lungs.
    • Impalement.
    • Severance (full or partial).
    • Third-degree burn on 9% or more of the body.

    The Legislature will now be required to give final ratification because the rule is likely to cost municipalities more than $200,000.

Missouri

  • The maximum weekly benefit for temporary total disability, permanent total disability and death benefits rose to $981.65, effective July 1. Permanent partial disability rose to $514.20.

New York

  • Mandated comp coverage for farm laborers under the Farm Laborers Fair Labor Practices Act, which requires farm employers to provide workers compensation for laborers, institutes injury reporting requirements and offers laborers additional protections, takes effect Jan. 1, 2020.

Virginia

  • The Workers’ Compensation Commission released its 2018 Annual Report, which provides a summary of key initiatives, trends, and outcomes.

Wisconsin

  • Commissioner of Insurance approved an overall 8.8% rate decrease for businesses starting Oct. 1, the fourth consecutive year of decreases.


For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit 
www.StopBeingFrustrated.com

Things you should know

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:

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

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com