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GAO Concludes That Improvements Are Needed to Enchance Medicare's Secondary Payer Debt Recovery Process

 GOA concluded in a recent report that Medicare's system for recovering MSP debt from EGHP's is no longer cost-effective. CMS presentl;y is recovering only 38 cents for every dollar it spent on recovering activities in fiscal-year 2003. A major finding was that contractiors were funded at a rate that exceed their workload. The report also found that CMS failed to trnsmit cases to contractors and that inhibited recovery. CMS plans to launch a new recovery system that has been undevelopment for the last 6 years to increase the efficiency of its recovery operations.

Vioxx Recalled Worldwide

 Vioxx was voluntarily recalled on September 30, 2004, by drug giant Merck following information that people taking Vioxx are twice as likely to have heart attacks and strokes as people who take older anti-inflammatory drugs, such as naproxen. 

Workers' Compensation News - October 12, 2004 Volume 2 Issue 239

Vioxx Recalled Worldwide--How to Apply for a Handicapped Placard--Ford Door Latch Personal Litigation--CMS Assist(tm) - New Support Group for Professionals--Gelman to Speak at NOSSCR on Medicare

Workers' Compensation News - January 25, 2004 Volume 2 Issue 4

Silica Exposure and Systemic Vasculitis: Work in Department of Energy (DOE) facilities has exposed workers to multiple toxic agents leading to acute and chronic diseases. Many exposures were common to numerous work sites. Exposure to crystalline silica was primarily restricted to a few facilities. -- President Bush Recognizes $2 Billion Federal Workers' Compensation Losses: The cost of Federal workplace injuries, when measured by workers' compensation losses, is more than $2 billion and 2 million lost production days annually. In fiscal year 2003, the Federal workforce of almost 2.7 million filed more than 168,000 injury claims. -- Amicus to "twist government's arm" on corporate crime: A trade union says it intends to increase the pressure on ministers if the government fails to introduce a corporate killing law.  

Workers' Compensation News - September 27, 2004 Volume 2 Issue 238 Workers' Compensation News - September 27, 2004 Volume 2 Issue 238

 A Failed System of Health Care Delivery: The Workers’ Compensation System in New Jersey, Rutgers Law Record, Rutgers Newark School of Law, Vol. 28 Rutgers L. Rec. 3 (May 1, 2004) published Saturday, 25 September, 2004; internet site: (Report to the Labor Committee, NJ Assembly, recommendations for reform of the Workers Compensation system).

Workers' Compensation News - September 15, 2004 Volume 2 Issue 237

WELDER AWARDED BENEFITS FOR NEUROLOGICAL INJURIES--PA panel affirmed workers' compensation benefits for welding fume exposure and neurological injuries. The Court held that the claimant's neurology expert gave scientifically competent testimony. 

CMS Publishes Final Rule Changing the Way It Will Calculate Interest on Medicare Secondary Payer Debt

 Interest is calculated from the date of the final determination and is owed if the amount of the overpayment or underpayment is not paid within 30 days. Interest accrues daily but is assessed and calculated in 30-day periods. A period that is less than 30 days is considered to be a full 30-day period.

Workers' Compensation News - September 1, 2004 Volume 2 Issue 235

TWO FINANCIAL TITANS AVOID CARING FOR INJURED WORKER Injured woman spends her retirement funds, still can't get care. A claimant has been waiting and waiting for temporary disability benefits or medical treatment for over a year. 

New Jersey Workers' Compensation Payments Rose 7.9 Percent in 2002 Due Mainly to Medical Spending That Skyrocketed to 15.3%

 NASI Study Finds Slow Economy and Medical Spending Affect National Trends. In New Jersey, workers' compensation payments increased to $1,471 million in 2002, a rise of 7.9 percent from the 2001 level of $1,363 million, according to a new report released by the National Academy of Social Insurance (NASI). Workers' compensation pays for medical care and cash benefits for workers who are injured on the job or become ill due to job-related causes.

First HIPPA Conviction Results in Jail Sentance

 A 42 year old male from in Seattle, Washington pleaded guilty today in federal court in Seattle to wrongful disclosure of individually identifiable health information for economic gain. This is the first criminal conviction in the United States under the health information privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA) which became effective in April, 2003. Those provisions made it illegal to wrongfully disclose personally identifiable health information.

 The occurrence of severe lung disease in workers who make flavorings or use them to produce microwave popcorn has revealed an unrecognized occupational health risk. Flavorings are often complex mixtures of many chemicals [Conning 2000]. The safety of these chemicals is usually established for humans consuming small amounts in food [Pollitt 2000], not for food industry workers inhaling them

CMS Will No Longer Allow Administrative Costs to Be Charged To The Set-Aside Arrangement

CMS issued a memorandum on prohibiting costs to be chargeable against Medicare set-aside arrangement funds.The purpose of this All Regional Administrators memorandum is to replace the policy that was outlined in the answers to questions in the All Associate Regional Administrators (ARA) memorandum concerning Workers’ Compensation Commutation of Future Benefits (issued on July 23, 2001, attached) and in the answer to question seven from the April 21, 2003 Frequently Asked Questions (FAQ).

Workers' Compensation News - August 18, 2004 Volume 2 Issue 232
 Medicare Expands Drugs Available Under Program to Help Beneficiaries with Severe Illnesses - A New CMS/MSP Issue for Reimbursement? For these...
Workers' Compensation News - August 4, 2004 Volume 2 Issue 231
CALIFORNIA-New law delays workers' comp for many. Jesse Ceniceros was at the top of his profession as a mechanic for Lockheed Martin when he was injured on the job and fell into California's workers' compensation maze.
Workers' Compensation News - July 28, 2004 Volume 2 Issue 230

NEW JERSEY: MORRIS COUNTY BARS AND RESTURANTS BRACE FOR SMOKING BAN. "Bars and restaurants are public accommodations and shouldn't be allowed to have carcinogens in the air," said Regina Carlson, executive director of the New Jersey Group Against Smoking Pollution, known as NJGASP. 

Workers' Compensation News - June 9, 2004 Volume 2 Issue 23 CompAssist (tm)

 MEDICAL GUIDELINES IN WC CASES APPROVED BY TEXAS SP CT. "In this opinion, we conclude that the Legislature authorized TWCC to set upper limits on reimbursement amounts and establish a reasonable time limitation on requests for medical dispute resolution. TWCC acted consistently with the Legislature’s mandates - (1) the establishment of fair and reasonable guidelines designed to ensure quality medical care for injured workers, TEX. LAB. CODE § 413.011(b), (2) the achievement of effective medical cost control in the workers’ compensation system, id., and (3) the establishment of a program for resolution of disputes regarding health care treatments and services, id. § 413.013(1). "

Texas Workers' Compensation Commission v. Patient Advocates of Texas, et al, Decided May 28, 2004.
CMS Enters into Data Exchanges with State Agencies Including California

 At a recent meeting in Atlanta GA, CMS (Centers for Medicare and Medicaid Service) announced State Workers’ Compensation Data Exchanges. 

NJ Division of Workers' Compensation Proposes New Rules For Asbestos Exposure Claims

Approximately six months after the enactment of very controversial legislation purportedly to aid victims of asbestos related disease, the NJ Department of Labor promulgated proposed rules that require the production of extensive amounts of information in order to obtain benefits from the Uninsured Employers Fund. Asbestos related disease is a latent condition that takes decades to manifest in such illnesses such as: asbestosis, lung cancer and mesothelioma. Unfortunately the disease, ie. mesothelioma, is irreversible, extremely debilitating and sometimes fatal in 6 to 9 months after diagnosis and the victim is left to endure the struggle for life without medical benefits and temporary disability benefits. While the legislature’s intentions were good in concept a serious questions remains as to whether the legislation and the proposed Rules meet the remedial and expeditious philosophy of the Workers’ Compensation Act.

NJ Division of Workers' Compensation Proposes New Rules For Asbestos Exposure Claims

Approximately six months after the enactment of very controversial legislation purportedly to aid victims of asbestos related disease, the NJ Department of Labor promulgated proposed rules that require the production of extensive amounts of information in order to obtain benefits from the Uninsured Employers Fund. Asbestos related disease is a latent condition that takes decades to manifest in such illnesses such as: asbestosis, lung cancer and mesothelioma. Unfortunately the disease, ie. mesothelioma, is irreversible, extremely debilitating and sometimes fatal in 6 to 9 months after diagnosis and the victim is left to endure the struggle for life without medical benefits and temporary disability benefits. While the legislature’s intentions were good in concept a serious questions remains as to whether the legislation and the proposed Rules meet the remedial and expeditious philosophy of the Workers’ Compensation Act.

 Effective Tuesday, July 6, 2004 the NJ Division of Workers' Compensation is operating under new rules concerning: initial pleadings; motions for temporary & medical benefits; suveillance tapes; substitutions of attorney; and the Uninsured Employers Fund. Administrative discussion of the comments submitted and the new rules are listed below.

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