Posts Tagged ‘repackaged drugs’

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

Tags: , , , , ,
Posted in News roundups, Research | No Comments »

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!

Tags: , , ,
Posted in Business, Medical Issues, State News | No Comments »

Risk, mining industry growth, drug repackaging, E&O, SIGS & more news of note

Monday, June 4th, 2012

Risk roundup – Nina Kallen posts the latest Cavalcade of Risk at Insurance Coverage Law in Massachusetts – check it out.
Mining – Joe Paduda talks about the growth of the mining industry, noting that it is up almost 60% over the last ten years, with an increase of 12% since the beginning of 2011 – a growth rate that looks like it will surpass the BLS ten-year projection of 24%. Joe notes that regulators, work comp executives and providers should be on alert since this growth will have a dramatic impact on selected states, citing North Dakota as one example.
Disparity in healthcare costs – Dave DePaolo has an interesting post on the wide disparity in cost for cash paying patients vs insurance. He points to a recent LA Times article that cited numerous real world examples (routine blood work was charged $782 by the hospital, $415 by the insurer, and $95 if paid in cash.) DePaolo asks: “What would fee schedules look like if those in charge of these pricing decisions shared with payers and regulators all of the data that identified each friction point in insurance based reimbursement schedules versus getting paid cash?”
Florida drug repackaging – Do the people who write the biggest checks to politicians determine the cost of workers comp in Florida? That’s a question many keep raising, and it appears so. In the article drug-bill battle is lucrative for lobbyists, legislators, Aaron Deslatte of The Orlando Sentinel talks about how Broward County’s Automated Health Care Solutions has invested nearly $6 million into lobbying to protect the practice of drug repackaging by physicians. Why should this issue be of concern to Florida employers and insurers? Joe Paduda offers a primer on repackaged drugs and the effect on work comp costs.
E&O and workers comp – Workers’ compensation is the leading cause of agent in E&O claims, accounting for approximately 10% of all claims annually, according to Curt Pearsall. He notes the majority of claims involve the following issues: Questions involving coverage for sole proprietors, partnerships or single-member LLCs; Dealing with a broker to place coverage for that “tough” risk; Dealing with the state workers’ comp market to place coverage; Ensuring employees in all states are covered; Placing clients in a trust/alternative program; and U.S. Longshoreman and Harbor coverage.
On reforming SIGS – At LexisNexis Workers’ Compensation Law, John Stahl offers a summary and some of the salient points of the International Association of Industrial Accident Boards and Commissions’ (IAIABC) recent report on self-insurance groups (SIGs): Regulatory Challenges Regarding Self-Insured Groups: Failures Prompt New Regulation. He notes that employers liked the low cost of joining an SIG but did not realize the potential liabilities associated with that choice, and that many employers made the false assumption that they were protected by state regulation. The full IAIABC report is available for $45: Self-Insured Groups for Workers’ Compensation: Effective Regulatory Strategies.
CA protects hair care workers – Jon Gelman posts about a groundbreaking settlement in California that protects hair care salon workers. The settlement was between California’s Attorney General and manufacturers of Brazilian Blowout hair smoothing products that contain a cancer-causing chemical. In addition to paying fees and penalties and implementing safeguards for workers, hair care facilities must warn the public about the cancer-causing potential of the chemicals used in the procedure and must cease deceptive advertising.
Poultry workers push back – Citing concerns over worker and public health, poultry workers, safety advocates, and groups ranging from the Southern Poverty Law Center and the National Council of LaRaza, to the American Public Health Association and Nebraska Appleseed all united in opposition to USDA’s proposed ‘modernization” plan that would shift work from inspectors to workers. At The Pump Handle, Celeste Monforton talks about this issue: Public health officials urge USDA to withdraw plan to ‘modernize’ poultry inspection, worker and food safety will suffer.
A Request for Help Bob Wilson calls all UR hands on deck for participation in Health Strategy Associates’ survey. Learn more here: Your Opinion Needed on Critical Utilization Management Survey.
Migration from Mexico – Peter Rousmaniere posts about a recent Pew Hispanic Center Report on Mexican migration, which states that, “The largest wave of immigration in history from a single country to the United States has come to a standstill. After four decades that brought 12 million current immigrants–more than half of whom came illegally–the net migration flow from Mexico to the United States has stopped–and may have reversed.”
Some of the factors cited as contributing to this change include the weakened U.S. job and housing construction markets, heightened border enforcement, a rise in deportations, the growing dangers associated with illegal border crossings, the long-term decline in Mexico’s birth rates and changing economic conditions in Mexico.
it would be funny if it weren’t so true – Cartoonist Jen Sorenson issues An Open Letter To The Supreme Court About Health Insurance.
Death on the Job The Weekly Toll.
More noteworthy news

.

Tags: , , , , , , , ,
Posted in News roundups | No Comments »

Risk, repackaged drugs, bizarre cases and other news notes

Wednesday, January 11th, 2012

Risk Roundup – Political Calculations blog hosts this week’s Cavalcade of Risk, replete with a post rating system. Check it out.
Florida repackaged drugs issue redux – Dave DePaolo posts about a new effort to put a price cap on Florida’s repackaged drugs. He posits that changing economic and regulatory conditions might create a more favorable climate for passage. He also talks about how “capping the price of drugs has been hotly contested by the Florida Medical Association (FMA) and a company called Automated Healthcare Solutions (AHCS).” AHCS is a firm whose executives have contributed heavily to politicians to prevent such legislation. A Tampa Bay news report talks about how the state’s pill mill crackdown was held up by proponents of doc dispensing, including AHCS principals: “The two Miramar workers’ compensation doctors have helped pump about $3 million into the political system through a dozen companies in the past year.” A story in the Florida Independent covers an earnings report for top lobbyists, noting that, “Among the companies to have spent the most on lobbying is Automated HealthCare Solutions, a group whose co-chairmen have become fixtures on the political scene. According to the Current, Automated HealthCare has posted minimum lobbying expenditures greater than $300,000.” For more on why repackaging controls are needed, see Joe Paduda’s posts: Drug Dispensing by Docs and Repackagers and the myth of AWP.
The big five – Roberto Ceniceros reports that Top 5 workplace injury causes make up 72% of direct workers comp costs, according to a research report by Liberty Mutual Group. “Overexertion–or injuries caused by lifting, pushing, pulling, holding and carrying–costs businesses $12.5 billion in direct annual expenses and accounts for more than 25% of the national burden.” This was followed by falls on the same level, falls to a lower level, bodily reaction, and struck by object.
Violence in Nursing – In When it hurts to help, Victoria Ison reports on workplace violence in nursing. Many might assume most violence is perpetrated by patients or intruders but not so: “Assistant nursing professor Cindy Thomas said the most common form of violence currently seen in health care occurs between nurses. She said violence between physicians and nurses is second, and violence between patients and nurses is actually third most common.”
Strange suits – Top 10 Bizarre Workers’ Comp Cases for 2011. From an eye-related injury after hitting a bowling ball with a sledge hammer to a fall from a helicopter while attempting to capture a deer with a net – read Thomas Robinson’s picks for workers comp lawsuits with strange circumstances. Robinson reminds us that, “one must always be respectful of the fact that while a case might be bizarre in an academic sense, it was intensely real, affecting real lives and real families.”
Brief takes

Tags: , , , ,
Posted in News roundups | Comments Off on Risk, repackaged drugs, bizarre cases and other news notes

Health Wonkery and other news of note

Thursday, October 13th, 2011

Health Wonkery – Christopher Fleming hosts Health Wonk Review Unadorned at the Health Affairs Blog. Check out the latest from the best of the health policy bloggers. And if healthcare is of concern to you, Health Affairs should be a regular read!
Bad behavior – When it comes to bad behavior, we are equal opportunity finger pointers. We’ve seen fraudulent employees. We’ve seen terrible bosses. We’ve seen bad brokers, bad insurers, and quack docs. Fraud is a game everyone can play and no one has a corner on the stupidity market. Among the recent crop of losers, we start with a post from HR Web Cafe about a mean-spirited employer who got a smackdown from a labor judge for a rather unusual contest he used to “motivate” his workers to better performance. And also on the employer side of the house, we have a classic case of premium fraud by a California tree trimming business that failed to pay workers comp premiums, under-reported payroll by more than $2 million, and failed to pay taxes. On the employee side, Roberto Ceniceros tells the story of nightmare employees who let rage over a small thing turn into a tragic event.
Spying on Employees – Employment law attorney Heather Bussing offers some useful guidelines on employee privacy and what employers can monitor. This is a really good overview. We encourage reading the entire article. Here’s some of her take-aways: “If the employer owns the system, hardware or both, the employer can monitor employees’ use of it, including personal files and communications.
If the employee owns the system and hardware, the employer’s ability to view and obtain personal files depends on the whether the employee is using it at work, whether the employer has a legitimate interest in viewing the communication, what the state’s laws and employer’s policies are, and what the employee’s objective expectations of privacy are.”
Repackaged Drugs – Joe Paduda has been in the forefront of a crusade against the practice of repackaged drugs, which has been promoted as a convenience for patients, but in practice is a costly work around for fee schedules. This is one of those under-the-radar issues that many employers may not see, but in states where the practice is allowed, it is costing big bucks. Joe first talked about the practice in 2006, and has been regularly posting updates. He brings you the latest from the eye of the storm: Is Florida finally going to fix its (repackaged) drug problem?
OSHA – OSHA has recently issued Nail Gun Safety – A Guide for Construction Contactors. OSHA says that nail gun injuries are responsible for approximately 37,000 emergency room visits annually. “These injuries occur as a result of unintended nail discharge; nails that bounce off a hard surface or miss the work piece and become airborne; and disabling the gun’s safety features, among other causes. Injury prevention is possible if contractors take steps such as using full sequential trigger nail guns; establishing nail gun work procedures; and providing workers with personal protective equipment.”
Child Workers – Celest Monforton gets the bureaucratic runaround when she tries to find out why child labor regulations were delayed by the White House’s Office of Management and Budget. A Labor Department update to the 40-year old regulations were stalled for 9 months – meanwhile, two teens lost legs in a grain auger accident, precisely the type of event that made such an update to regulations imperative.
Excess Loss Development – NCCI had released a new research report on Workers Compensation Excess Loss Development. They note that, “Large loss and excess development is relevant to calculating excess loss factors used in retrospective rating.”
News Briefs

Tags: , , , , , , , ,
Posted in News roundups | Comments Off on Health Wonkery and other news of note

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

Tags: , , , , , , ,
Posted in News roundups | Comments Off on All Hallows Eve Edition of Health Wonk Review and other noteworthy news