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Workers' Compensation Crisis: The Physicians Have Left the Building

Physicians in several states are not taking any new workers' comp cases. Their complaints are many: low pay being the #1 reason, as well as high overhead and costs of treating injured workers, delays in dealing with Utilization Review companies, time and effort to fill out reports, regulatory burdens...

Denis Paul Juge on Status of the Preferred Provider Organization Litigation in Louisiana: What's The Problem?

Litigation has been filed in both federal and state courts in Louisiana concerning the discounting of payments by silent PPOs to healthcare providers for medical services that are provided to patients for treatment under the Louisiana workers’ compensation act. This commentary, written by Denis...

The Silent PPO Problem for Workers' Compensation Medical Providers

For many years now, medical providers who enter into contracts with preferred provider organizations (PPOs) have had their bills for medical services reduced in accordance with the terms of the contract. The PPO creates a network of providers who have agreed to these discounts. A silent PPO is created...

Regulating Silent PPO's: Tennessee Physicians Fight Back

In legislation backed by the Tennessee Medical Association (TMA), the Tennessee legislature has enacted new laws to regulate silent PPO's effective January 1, 2008. The silent PPO problem is more prevalent in workers' compensation than in any other area, thereby threatening physician participation...

Stephen C. Embry on Managed Care Is No Care: Connecticut's Medical Fee Schedule and the Medicare Resource Based Relative Value Scale

Connecticut recently joined a growing list of states that use Medicare Resource Based Relative Value Scales (RBRVS) for setting medical fees in workers' compensation cases. [Conn. Gen. Stat. § 31-280] If experience with other states is of any value in predicting the future, workers in Connecticut...

Vernon R. Sumwalt on the Physician-Patient Privilege in Workers' Compensation Cases Since the Enactment of N.C. Gen. Stat. Sec. 97-25.6

For years, many appellate decisions in North Carolina have looked at the propriety of communications between parties and medical providers during litigation. Popularized by the medical malpractice case of Crist v. Moffatt, 326 N.C. 326 , 389 S.E.2d 41 (1990), the physician-patient privilege has become...

MRSA Infection Control: Best Practices

Until recently, most people had never heard of staphylococcus aureus. Now methicillin-resistant staphylococcus aureus (MRSA) seems to be a topic of discussion for most households, workplaces and water coolers. Although there was fear among the general population, healthcare organizations, public health...

Illinois Workers Compensation Medical Fee Geozips

Critics decry the current WC Medical Fee Schedule as not recognizing enough real present medical cost savings but, if they look at historical rates of medical cost inflation, they would see the true value of the present WC Medical Fee Schedule in capping the rate of medical inflation and not in the immediate...

Study Reinforces Links Between Formaldehyde and Cancer

A study released last week by the National Cancer Institute strengthens the link between exposure to formaldehyde and several forms of cancer, including leukemia. The 30-year study, which tracked the health of nearly 25,000 men exposed to the chemical in industrial plants, is likely to impact a long...

Workers' Compensation, Arthritis and Degenerative Disc Disease

When a work injury aggravates, reactivates or accelerates your arthritis or degenerative disc disease, you have a right to file for workers' compensation benefits. There is considerable misunderstanding concerning the right of an employee to obtain these benefits for an aggravation of a preexisting...