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February 26, 2008 9:36 AM
Workers' Compensation News - February 26, 2008, Volume 5 Issue 501

NJ JURY AWARD $30.3 MILLION - MESO TRIAL - FEB. 2008
HACKENSACK, N.J. -- A jury has reached what is believed to be the highest
asbestos verdict ever in New Jersey, awarding $30.3 million to the surviving
family members of a former automotive worker.

NJ APPLICATION TO DESIGNATE ASBESTOS LITIGATION AS A MASS TORT FOR CENTRALIZED MANAGEMENT
Pursuant to Directive # 10-07, "Mass Torts - - Revised Guidelines and Criteria for Designation", an application has been made to the Supreme Court, through the Acting Administrative Director of the Courts, to designate all New Jersey state court asbestos litigation as a mass tort and assignment of that mass tort to Middlesex County (Judge Ann G. McCormick) for centralized management purposes.
Anyone wishing to comment on or object to this mass tort application should provide such comments or objections, with relevant supporting documentation, to the Acting Administrative Director of the Courts, P. O. Box 037, Trenton, NJ 08625-0037, by March 31, 2008.

ASBESTOS SCHOOL SCARE RESULTS IN EMPLOYEE REFERRAL TO WC
Since an asbestos scare at Broomfield High School in December, the Boulder Valley School District has spent $10,695 for abatement and subsequent testing, and 19 staff members have received workman’s compensation referrals.
http://dailycamera.com/news/2008/feb/26/asbestos-scare-spurs-workmans-comp-referrals/

WHAT'S NEW IN WORKERS' COMPENSATION
Blog: http://workers-compensation.blogspot.com/

PUBLISHED: 2008 WORKERS' COMPENSATION LAW POCKET PARTS
New features and recent developments in the 2008 Pocket Parts include:

• These pocket parts provide information concerning the Asbestos Fund,
which has been established for those entities where workers'
compensation coverage cannot be established. The newly designed
forms that need to be utilized in filing for benefits are included. Also,
the newly designed Motion for Temporary and Medical Benefits,
including the required Certification, is provided and discussed..

• The newly revised Judgments for Total and Permanent Disability are
included. The Judgments include new refinements in offsets for
pensions and Social Security disability benefits.

• The recently promulgated administrative rules governing the
disposition of Temporary Disability Benefits are discussed. The nonduplication
of benefits provisions are reviewed including the multiple
agency adjudication process.

• Collateral medical benefit issues are discussed in light of the recent
Supreme Court decision concerning this matter, including a Motion to
Join the Collateral Health Carrier and sample Certifications to be used
in support of the application.

• Additionally, these pocket parts provide information concerning the
new rules of the Division of Workers' Compensation embodying
electronic filing requirements and new procedures involving both
formal and informal proceedings, motion practice, post judgment
process, and judicial performance. The expanded Medicare secondary
reporting requirements and the mandatory coordination of benefits are
reviewed in this supplement. The recovery aspects of Medicare
conditional payments as well as future medical provisions are updated
and discussed. The new Child Support Lien distribution forms,
computation worksheets and judgments are provided and explained in
depth.

• This pocket part also discusses recent changes in the application for
counsel fees. The supplement includes the newly promulgated
administrative directive embodying those changes
http://west.thomson.com/product/17152728/product.asp


WC MEDICAL COST TRENDS
http://www.joepaduda.com/
"Market size - the WC medical market was about $27 billion in 2007 and is increasing at around 8% per year.

Segments (percentage of total spend by category)
(actual results may vary depending on location and definitional differences)
Hospital and facility - 30%
Physician services - 22%
Pharmacy - 15%
Physical medicine (PT and Chiro) - 21%
Imaging - 6%
DME, home health, lab, other - 6%

Major players - general managed care services
Coventry (includes Focus, First Health, and Aetna networks marketed by Coventry) - $700+ million
CorVel - $300 million
Genex - $200 million
Intracorp - $200 million

Key issues
fee schedules - a majority of states control prices paid to providers via fee schedules, others use UCR as basis for reimbursement
managed care regulations - different states have very different regulatory environments, with some favoring strong programs with lots of employer control eg FL and NJ, while others are much more employee focused eg NY, and others seem to favor providers eg IL
Claims frequency is declining, meaning the annual number of claims has decreased for the last 15 years by over 50%...and this trend is continuing
Group health players occasionally dip their toes in the murky waters of WC, but in the last ten years, the only one to stick it out has been Aetna
Trends

Consolidation - Coventry is looking to make this a big part of its business, and is investing heavily in acquisitions and absorption thereof to generate top line, and secondarily bottom line.
The rise of the specialists - Specialty managed care companies are eating the generalist PPO's lunch (and stealing their lunch money too) - companies such as MedRisk (physical medicine management and HSA client) and FairPay Solutions (facility bill review and also HSA client) and OneCall Medical (imaging) are 'hollowing out' the generalist PPOs' revenue stream by doing a much better job of managing their niche businesses
Drive to outcomes - yes, after 12 years of talking about it, I'm finally starting to see some real movement from payers towards attempting to identify and direct claimants to the best providers."
***
CALENDAR
AAJ NATIONAL CONVENTION
WORKERS’ COMPENSATION AND WORKPLACE INJURY SECTION
Philadelphia Marriott Hotel
Tuesday, July 15, 2008

Chair and moderator: A. Harold Du Bois, MD
“Success Principles” Applied to the Legal Profession, Samy Chong, Canada, Lawrence D. Levin, PA
The Future of Workers’ Compensation: Navigating the New Benefit Highway, Jon L. Gelman, NJ
Subrogation in the Handling of Workers’ Compensation and Third-Party Claims, George Martin, PA
Registration
http://www.atla.org/convention/PA08/docs/BrochurePA08.pdf
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