Posts Tagged ‘physician dispensing’

News roundup: Risk, Dispensing Docs, Costs for Employees, Litigation & more

Wednesday, October 3rd, 2012

Risk roundup – Our Down-Under friend Russell Hutchinson of Chatswood moneyblog posts this week’s Cavalcade of Risk, with a global roundup of posts. Check it out.
Costs for Employees – Insurance Journal reports on the latest Bureau of Labor Statistics report on the cost of U.S. employees, noting that the nationwide average cost for private industry employers was $28.80 per hour worked in June 2012. “The costs ranged within each region, with total compensation costs of $24.44 in the East South Central division to $33.47 in New England.” The article offers more detail on the report, noting that costs were collected from a sample of 47,400 occupations from about 9,500 establishments in private industry. Data excludes self-employed and farm and private household workers.
Physician Dispensing – Joe Paduda looks at potential conflict of interest issues in a post about ABRY Partners, he asks, “How is it that an investment firm owns stakes in a TPA, MSA company, subrogation firm – and a physician dispensing and billing company?” Is one company cleaning up a mess that another company makes? In other repackaging news, he notes that Miami-Dade Schools has taken a stand on physician-dispensed repackaged drugs – they are refusing to pay the markups, a move that saved more than half a million dollars. Employers take note: Is this a potential area of savings in your comp program.
Narcotics Studies – Rita M. Ayers reports on a recent study by Accident Fund Holdings and Johns Hopkins University that links opioid use to an escalation in overall claim cost in the Tower MSA Blog. She notes that the study reveals that 55% to 85% of injured workers receive narcotics for chronic pain. She says that the study, “…examined the interrelationship between the utilization of short- and long-acting opioid medications and the likelihood of claim cost escalating to a catastrophic level (> $100,000). Analyzing 12,000 workers’ compensation claims in Michigan during a four-year period, the study focused on whether the presence of opioids alone accounted for the cost increase or whether costs increased because opioids were associated with known cost-drivers, such as legal involvement and injury severity.” Related: WCRI: Nearly 1 in 12 Injured Workers Who Started Narcotics Still Using 3-6 Months Later.
Worst States for Lawsuits – “Lawsuit Climate 2012″ is a study evaluating how fair and reasonable states’ tort liability systems are perceived by businesses in the U.S. It was conducted by the U.S. Chamber Institute for Legal Reform. According to those surveyed, Delaware has the best legal climate for businesses.See respondents’ picks for the Top 10 Worst States for Lawsuits, along with more on the study’s results.
High Costs for Police Dept. – The LA Daily News reports that Los Angeles spends more on LAPD workers’ comp claims than for all others combined – some $65 million in 2010-2011 alone. The department averages 250 claims a month. Authorities say that it is “…one of four drivers of the city budget deficit. Others include the costs of salaries, pensions and health care.”
News Briefs

Addendum As a follow-on to yesterday’s post about Shackleton’s Medical Kit, we found more information and a photo of Shackleton’s medical kit at The Science Museum of London, and a related post from NPR’s Health Blog: ‘Cocaine For Snowblindness’: What Polar Explorers Packed For First Aid.
shackleton-medical-kit.JPG

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Physician drug repackaging, front and center

Thursday, July 12th, 2012

The drum that our colleague Joe Paduda has been beating for several years – the outrageous cost of repackaged drugs in Florida – appears to be resonating. This esoteric little nook and cranny of workers comp that is costing employers millions across many states would normally not attract much attention in mainstream media – heck, even a lot of grizzled workers comp vets weren’t conversant with the practice or the potential adverse affect on costs. But yesterday, the issue made the business section of the New York Times in an article by Barry Meier and Katie Thomas, Insurers Pay Big Markups as Doctors Dispense Drugs. They sum up the crux of the matter: “At a time of soaring health care bills, experts say that doctors, middlemen and drug distributors are adding hundreds of millions of dollars annually to the costs borne by taxpayers, insurance companies and employers through the practice of physician dispensing.” The article goes on to note that, “The practice has become so profitable that private equity firms are buying stakes in the businesses, and political lobbying over the issue is fierce.”
Florida and the case of Automated HealthCare Solutions are used as examples in the article. We’ve leave you to follow the excellent job the reporters do in outlining the issue, tracking down connections, and showing how a recent legislative attempt to close this costly loophole was squelched. Alan Hays, the Republican state senator in Florida who introduced the defeated bill said that, “The strategy of the people that were opposed to this bill was to put the right amount of dollars in the right hands and get the bill blocked,” he said. “And they were successful in doing that.” That defeat is costing employers and taxpayers some $62 million, according to the state’s insurance commissioner.
Don’t miss the accompanying infographic, Paying Much More in the Doctor’s Office. Also note the 424 comments to the article, which we are still perusing at this time – it’s not often that a detailed workers’ comp issue garners that much attention in the so-called mainstream press.
We give a big tip of the hat to Paduda, who has posted on the Florida repackaging issue repeatedly. going back several years, despite some personal jeopardy in the form of a threatened lawsuit, later dismissed by a federal judge.
How Connecticut is dealing with Physician Drug Repackaging
In February, Paduda posted that physician dispensing was coming to Connecticut and urged his readers to contact regulators. At Evidence Based blog, Michael Gavin posts an update: Connecticut Gets Drug Repackaging Right: Removing the Financial Incentive. Interestingly, this was done via a rule change rather than a statutory change. Plus, it does not ban the practice of physician dispensing, and it even allows a reasonable administrative fee. Gavin suggests that these central tenants of an effective regulatory approach to repackaged drugs might serve as a model for other states. Florida, take note!

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Superhero Health Wonk Review and other news of note

Friday, October 28th, 2011

Joe Paduda hosts The Superhero Edition of Health Wonk Review, in which he attributes superpowers to our regular health wonk contributors and cites them for doing battle with tough issues. My question is when are we going to get the costumes, Joe?
By the way, while you are at Joe’s blog, don’t overlook his smoking gun post Physican dispensing – boy do we have a deal for you!
Good news – DOL reports that private industry workplace injuries and illnesses declined in 2010. They fell to a rate of 3.5 cases per 100 equivalent full-time workers, down from 3.6 cases in 2009. But the more serious cases are holding constant: More than one-half of the 3.1 million private industry injury and illness cases reported nationally in 2010 were of a more serious nature that involved days away from work, job transfer, or restriction–commonly referred to as DART cases.
Wellness – Ezra Klein covers Cleveland Clinic’s wellness program in Health Care’s Brave New World of Compulsory Wellness. The program is not without some controversy, but it appears to be working: “Not only has the clinic cut its health-care costs, but its employees are also getting healthier in measurable ways. Workers have lost a collective 250,000 pounds since 2005. Their blood pressure is lower than it was three years ago. Smoking has declined from 15.4 percent of employees to 6.8 percent.”
See you there? – we’re getting close to two important industry events, and we’ll be at both. From November 9 to 10, we’ll be at the National Workers Compensation & Disability Conference in Las Vegas. If you are attending, why not meet up at Mark Walls’ Link UP reception at 5 pm on Wednesday? We’ll also be at the WCRI’s 28th Annual Issues & Research Conference in Boston on November 16 and 17. We’re looking forward to both. Drop us a line if you will be attending too.
Sneak peek – Business Insurance has had a redesign and is offering an “open house” through the 31st of the month. Here’s the workers’ comp section – if you read Workers Comp Insider regularly, you know we are a Roberto Ceniceros fan. The whole publication is worth a glance, BI has an excellent staff of reporters many of whom have been with the publication for years.
Get your fright on – In honor of Halloween weekend, we thought this feature on 8 Terrifying Robots Now Stalking Your Local Hospital was appropriate – but be warned, the feature appears on an irreverent site and if you are at work, it might trigger your company’s net nanny filter. Also on a scary theme, we noted this recent study on Psychopathic bosses.
News Briefs

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Cavalcade of Risk & workers comp news briefs

Wednesday, January 12th, 2011

It’s Cavalcade of Risk week and issue #122 is hosted by our friend David Williams at Health Business Blog – check it out!
Industry pulse – Good news. Robert Hartwig of the Insurance Information Institute takes the pulse of the property casualty industry and sees signs of life: Insurance Industry On The Mend. “Mr. Hartwig said in comparison to all of 2009, the industry’s 2010 third-quarter results are close to all of the prior years. While the industry is not back to where it was prior to the economic downturn in 2007 when it reported property and casualty net income of $62.5 billion, it is performing significantly better than the worst of the downturn in 2008 when p&c income came in at slightly more than $3 billion.”
That’s good news, but it’s not time to break out the champagne yet. A.M. Best forecasts downward rating pressure for the commercial market and two new reports indicate that reinsurance prices should remain soft in 2011.
Physician dispensed drugs – If you are an employer or an insurer and this topic isn’t yet on your radar, it needs to be. Joe Paduda posts about recent NCCI report on physician-dispensed drugs in workers comp, a significant growth area that NCCI says is putting upward pressure on WC costs. California took steps to regulate the practice a few years ago after learning that repackaged costs were two to twelve times higher than the fee schedule.
Labor – The New York Times reports that cash-strapped states are looking to curb labor unions. Expect a flurry of legislative initiatives to limit the power of labor unions representing government employees. While both parties are wrestling with ways to keep state budgets in line, the article notes:
“But in some cases — mostly in states with Republican governors and Republican statehouse majorities — officials are seeking more far-reaching, structural changes that would weaken the bargaining power and political influence of unions, including private sector ones.”
Prevention works – A concerted campaign to reduce textile service worker injuries is working, according to the recently released annual TRSA Textile Services Industry Safety Report. Recordable injuries and illnesses dropped by 17 percent from 2008 to the 2009, and have dropped by 50% since 2005. Sandy Smith reports on SafeTRSA, an industry-wide safety initiative to improve worker safety through awareness, education and training.
Breast cancer & comp – At Comp Time, Roberto Ceniceros discusses City of Las Vegas v. Lawson. The Nevada Supreme Court ruled that a firefighter is entitled to a presumption that her breast cancer arose from her on-the-job exposure to benzene. His post also discusses male breast cancer.
Dramatic Australia flood footage – Office workers catch footage of a modest creek turning into a raging torrent sweeping cars away. More news and dramatic videos of the cataclysmic Australian flooding is available on MSNBC. At least 16 people are reported dead and more than 90 missing in what has been likened to an inland tsunami. Brisbane is under siege. You can follow breaking news on Twitter at #Brisbane.

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All Hallows Eve Edition of Health Wonk Review and other noteworthy news

Thursday, October 28th, 2010

The pre-election season used to be dubbed the silly season, but this year it might better be termed the scary season – things are getting pretty acrimonious. Following up on the scary theme, Meredith Hughes, Allison Levy, and Sam Wainwright of New Health Dialogue Blog team up to bring you Health Wonk Review: All Hallows Eve Edition. It’s an entertaining and substantive issue, and the last issue before the election.
And in other news of note:
Joe Paduda of Managed Care Matters tackles the issue of physician dispensed drugs in work comp and explains how repackaged drugs can add to costs by an alarming magnitude. In 2007, California closed this loophole that allowed repackaged drugs to go “off the grid” in terms of existing pricing controls, and other states are now looking at this issue. Joe’s post compiles research and explains why this is an issue you should know and care about.
Roberto Ceniceros of Comp Time looks at the NFL’s recent focus on helmet-to-helmet hits. He links to a press release from the NFL Players Association, which makes the point that player safety extends beyond the field, calling on the league to “call on the league to end “nasty litigation against nearly 300 players’ workers compensation cases and stop saying ‘no’ to the disability benefits of NFL legends.”
Yvonne Guibert of Complex Care Blog discusses obesity and comorbidities and the impact on claims costs. She offers research and resources to help employers grapple with this issue. The current issue of Human Resource Executive also carries a good article on how obesity adds to healthcare costs, along with some approaches that employers are taking to mitigate the problem.
For all practical purposes, Texas is the only state in the union that allows employers to opt out of mandatory workers comp coverage. Peter Rousmaniere takes a look at how the opt-out option has affected employers in the current issue of Risk and Insurance. And on the topic of opting out, see Good News for Texas Non-subscribers, Bad News for Excess Carrier, a post by Michael Fox of Jottings By An Employer’s Lawyer.
Advanced Safety and Health News Blog discusses and links to federal OSHA’s recently issued special evaluation of state-run OSHA programs. “The reports provide detailed findings and recommendations on the operations of state-run OSHA programs in 25 states and territories. The review was initiated after a 2009 special OSHA report on Nevada’s program, identified serious operational deficiencies in that state.”
Judge Tom of the eponymous blog schools us on Oklahoma’s law on recreational injuries and workers comp. In 2005, the law was tightened to exclude any injuries that stem from recreational and social activities, even those occurring on the employer’s premises. He notes: “The larger, unanswered question is whether employers no longer have tort immunity for injuries sustained at recreational and social functions such as Christmas parties, company sponsored sports leagues, the Orcutt basketball pick-up game, attendance at charitable events to name a few.”
Short takes
Weekly Toll: Death in the American Workplace
High Unemployment Rate a Drag on Workers’ Compensation Insurers
Health care group spends $4 million on safety, saves $14 million
Specialist and primary care pay per hour
FedEx to Pay $2.3 Million Over Independent Contractors

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News roundup: blogs, RTW, meth users, ethics, and more

Monday, February 6th, 2006

Insurance weblogs. We are featured in an article about weblogs by Therese Rutkowski that appeared in the December issue of Insurance Networking News: Online Soapboxes Get Down to Business. Several of our fellow bloggers are cited too.
Returning to Work: Overcoming Injury and Achieving Success – an article written by Kurt Schuhl and Michael McMahon the January issue of Risk Management magazine.
Meth abusers cost employers millions – A recent study determined that each meth-using employee costs his or her employer $47,500 a year in terms of lost productivity, absenteeism, higher health-care costs and higher workers’ compensation costs.
Off-the-job injuries – A Stockton California police officer was denied workers comp for an off-duty injury he suffered while playing basketball. According to the court: “When an employee is injured during voluntary, off-duty participation in a recreational, social, or athletic activity, Labor Code section 3600, subdivision (a)(9) provides that the injury is not covered by workers’ compensation, unless the activity was “a reasonable expectancy of” the employment or it was “expressly or impliedly required by” the employment.”
The Weekly Toll. – Tammy at Confined Space reminds us all of the real reasons why we should be doing the work that we do – a grim reminder to redouble our efforts to keep workers safe.
Immigrant worker injuries – Our colleague Peter Rousmaniere points to a recent Massachusetts study that offers a breakdown of hospitalizations by medical diagnosis, job and ethnic orientation. The study shows a relationship between the type of job and the type of injury.
Drug dispensing by docs – Joe Paduda notes that workers comp prescription drug costs are driven by utilization and price. But are some docs compromised by a profit motive via on-site dispensaries now in vogue?
Looking out for the workers – RawblogXport reminds points to an item that paints a dismal portrait of the economic status of the American worker, who is working harder and longer for less pay. “For the first time on record, U.S. household incomes failed to increase for five straight years – and that record includes the Great Depression. And the minimum wage, adjusted for inflation, is actually worth less today than it was before the last increase was passed 10 years ago”
Is the U.S. economy strong? – In terms of wages and jobs, the U.S. economy is not as strong as it might appear, according to some recent economic studies, and as reported recently in the New York Times.
Ethics – According to a survey by theAmerican Management Association (AMA), pressure from management to meet unrealistic business objectives and deadlines is the leading factor for most unethical corporate behavior. The desire to further one’s career and to protect one’s livelihood are ranked second and third, respectively, as leading factors.
Scandal watch. Speaking of ethics, Business Insurance reports that an AIG settlement with the SEC and the NY AG may be pending. Meanwhile, Judy Greenwald speculates that there may be bigger fish to fry in the wake of recent indictments of senior execs at General Re Corp. and American International Group Inc.

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