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CA: DWC Adjusts Section Of Medical Fee Schedule To Conform With Medicare Payment System

Sacramento, CA (CompNewsNetwork) - The Division of Workers' Compensation (DWC) has posted an order adjusting the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) section of the official medical fee schedule (OMFS) to conform with changes in the Medicare payment system as required...

CWCI Research Tracks the Continued Growth of California Workers’ Comp Medical Expenses

California workers’ compensation medical expenditures fell sharply immediately after the enactment of the 2002-2004 reforms, but that decline was short-lived, and after rising steadily since 2005, average payments for treatment, pharmaceuticals and durable medical equipment (DME), medical management...

Allstate Insurance's RICO Lawsuit Seeks to Recover $2.1M From Durable Medical Equipment Companies

Allstate Insurance Company is seeking to recover $2.1 million against 37 New York area defendants in its second insurance fraud lawsuit of 2011. The complaint, filed under the Racketeer Influenced and Corrupt Organizations Act ("RICO") and principles of the common law, alleges that the defendants...

Workers' Comp Fraud Blotter (9/15/2011) – Caterer Caught On Video Cooking and Coordinating Events While On Disability

Each week we'll be surveying what the media, state agencies, insurance companies, and others report in terms of workers' comp fraud. Just like a police blotter, our workers' comp fraud blotter lists recent arrests, charges, convictions and investigations. Workers' Comp Fraud...

Workers' Comp Fraud Blotter (9/15/2011) – Caterer Caught On Video Cooking and Coordinating Events While On Disability

Each week we'll be surveying what the media, state agencies, insurance companies, and others report in terms of workers' comp fraud. Just like a police blotter, our workers' comp fraud blotter lists recent arrests, charges, convictions and investigations. Workers' Comp Fraud Blotter...

The Year in Review: Top 10 Workers’ Comp Fraud News Stories

Workers’ compensation fraudsters come in all shapes and sizes. Here are 10 news stories from 2011 that caught our eye: 1. Grandpa Used Granddaughter to Sell His Workers' Compensation Drugs (OH) - Donald Fisher has pleaded guilty to one count of deception to obtain a dangerous drug, a fourth...

The Year in Review: Top 10 Workers’ Comp Fraud News Stories

Workers’ compensation fraudsters come in all shapes and sizes. Here are 10 news stories from 2011 that caught our eye: 1. Grandpa Used Granddaughter to Sell His Workers' Compensation Drugs (OH) - Donald Fisher has pleaded guilty to one count of deception to obtain a dangerous drug, a...

CWCI Study Tracks Growth of California Workers’ Comp Medical Payments

A new CWCI study on changes in California workers’ compensation medical payments finds that since accident year (AY) 2005 – the first year after the last round of workers’ compensation reforms – the average amounts insurers pay for medical services on work injury claims have jumped...

CWCI Study Monitors California Workers’ Comp Medical and Indemnity Trends

Payments for pharmaceuticals and durable medical equipment (DME) in California workers’ compensation continue to increase sharply, adding pressure against the recent reforms to the system according to a new CWCI study that examines medical and indemnity payment trends from accident years (AY) 2002...

New CWCI Study Looks at Independent Medical Review Outcomes in California Workers’ Comp

A new analysis of independent medical review decisions issued in 2014 suggests that the medical dispute resolution process mandated by the workers’ compensation reform bill enacted in 2012 is working to assure that the treatment provided to California injured worker meets evidence-based medicine...

CWCI Reviews California Workers’ Comp Q1 2015 Independent Medical Review Outcomes

A new analysis of 2015 independent medical review (IMR) outcomes shows there was no significant reduction in IMR volume in the first quarter of this year, even though the independent medical reviewers continue to concur with the utilization review (UR) physician’s denial or modification of treatment...