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

Things you should know

NLRB issues proposed rule on joint employers

As expected, the National Labor Relations Board (NLRB) has announced publication of a proposed rule on joint employers. The rule will effectively discard the expanded definition of joint employer in the Browning-Ferris Industries decision during the Obama era and return to the much narrower standard that it had followed from 1984 until 2015. An employer may be found to be a joint-employer of another employer’s employees only if it possesses and exercises substantial, direct and immediate control over the essential terms and conditions of employment.

NIOSH publishes guide on air-purifying respirator selection

NIOSH has issued a guide intended to help employers select appropriate air-purifying respirators based on the environment and contaminants at specific jobsites.

Top trend in workers’ comp reform – legislation impacting first responders

According to National Council on Compensation Insurance (NCCI), the introduction of legislation impacting first responders was the top trend in workers’ compensation reforms countrywide, although few bills have passed. In 2018, there were 103 bills dealing with first responders battling post-traumatic stress disorder or cancer, but only five bills passed. Washington and Florida both passed bills that would allow first responders with PTSD to file workers’ compensation claims under certain circumstances, and Hawaii and New Hampshire revised or enacted presumption bills for firefighters battling certain types of cancer. New Hampshire also passed a law that calls for a commission to “study” PTSD in first responders.

Worker fatalities at road construction sites on the rise: CPWR

A total of 532 construction workers were killed at road construction sites from 2011 through 2016 – more than twice the combined total for all other industries – according to a recent report from the Center for Construction Research and Training, also known as CPWR. In addition to the statistics, the report highlights injury prevention strategies for road construction sites from CPWR and several agencies.

State-by-state analysis of prescription drug laws

The Workers Compensation Research Institute published a report that shows how each of the 50 states regulates pharmaceuticals as related to workers’ compensation. Some of the highlights include:

  • 34 states now require doctors to perform certain tasks before prescribing
  • At least 11 states have adopted drug formularies
  • 15 states do not have treatment guidelines to control the prescription of opioids, and preauthorization is not required
  • In at least 26 states, medical marijuana is allowed in some form and nine of those states specifically exclude marijuana from workers’ compensation

Guide and study related to workers and depression

Workers who experience depression may be less prone to miss work when managers show greater sensitivity to their mental health and well-being, recent research from the London School of Economics and Political Science shows. The study was published online in the journal BMJ Open.

In March, the Institute for Work and Health published a guide intended to aid “the entire workplace” in assisting workers who cope with depression or those who support them.

11 best practices for lowering firefighter cancer risk

A recent report from the International Association of Fire Chiefs’ Volunteer and Combination Officers Section and the National Volunteer Fire Council details 11 best practices for minimizing cancer risk among firefighters.

NIOSH offers recommendations for firefighters facing basement, below-grade fires

The Workplace Solutions report offers strategies and tactics for fighting basement and below-grade fires, along with a list of suggested controls before, during and after an event.

Predicting truck crash involvement update now available

The American Transportation Research Institute has updated its Crash Predictor Model. It examines the statistical likelihood of future truck crashes based on certain behaviors – such as violations, convictions or previous crashes – by using data from 435,000 U.S. truck drivers over a two-year period.

This third edition of CPM includes the impact of age and gender on the probability of crashes. It also features average industry costs for six types of crashes and their severity.

State News

California

  • Governor signed four bills related to comp. A.B. 1749 allows the first responder’s “employing agency” to determine whether an injury suffered out of state is compensable. A.B. 2046 requires governmental agencies involved in combating workers compensation fraud to share data, among other changes to anti-fraud efforts. S.B. 880 allows employers to pay indemnity benefits with a prepaid credit card. S.B. 1086 preserves the extended deadline for families of police and firefighters to file claims for death benefits.
  • Governor vetoed bills that would have prohibited apportionment based on genetics, defined janitors as employees and not contractors, identified criteria doctors must consider when assigning an impairment rating for occupational breast cancer claims, called for the “complete” disbursement of $120 million in return-to-work program funds annually, and required the Division of Workers’ Compensation to document its plans for using data analytics to find fraud.
  • The Division of Workers’ Compensation revised Medical Treatment Utilization Schedule Drug List went into effect Oct 1.
  • Independent medical reviews (IMRs) used to resolve workers’ comp medical disputes in the state rose 4.4 percent in the first half of 2018 compared to the first half of 2017; however, in over 90 percent of those cases, physicians performing the IMR upheld the utilization review (UR) physician’s treatment modification or denial. – California Compensation Institute (CWCI)

Florida

  • Workers’ compensation coverage for post-traumatic stress disorder (PTSD) for first responders like firefighters, EMTs, law enforcement officers and others went into effect Oct. 1.

Indiana

  • Workers’ Compensation Board will destroy paper documents in settlements. If parties mail or drop off paper-based settlement agreements and related documents, it will trash them and notify the parties by phone or email to submit online. The board urges parties to follow the settlement checklist and procedure posted on its website.

Minnesota

  • The Department of Labor and Industry formally adopted a number of changes to fees for rehabilitation consultants.
  • Department of Labor and Industry approved rule changes that slightly increase fees for medical and vocational rehabilitation services, and increase the threshold for medical, hospital and vocational rehabilitation services that treat catastrophically injured patients.
  • Effective Jan. 1, the assigned risk rate, which insures small employers with less than $15,000 in premium, and employers with an experience modification factor of 1.25 or higher, will decrease 0.7%.

Missouri

  • A new portal from the Department of Labor offers safety data, video, and training programs.

New York

  • The Workers’ Compensation Board has launched its virtual hearings option for injured workers and their attorneys. For more information.
  • Attorneys or representatives are now required to check-in to all hearings using the online Virtual Hearing Center when appearing in person at a hearing center.

Virginia

  • The Department of Labor and Industry has issued a hazard alert warning of the potential dangers of unsafe materials handling and storage in the beverage distribution and retail industry.
  • The Workers’ Compensation Annual Report for 2017 shows claims and first report of injury are trending up, bucking the downward trend nationally. There has also been a big jump in alternative dispute resolutions.

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