I was stunned to read in a recent WorkCompCentral article (subscription required) that only 38 of the 63 firms currently providing workers’ compensation utilization review (UR) services in California are URAC accredited. Per California Senate Bill 1160, the deadline for mandatory accreditation was July 1, 2018. WorkCompCentral’s reported figures on July 9 mean that 40
For more than a decade, taxpayer-funded health care programs have seen a steady uptick in higher-paying billing codes. Office visits, outpatient services, and emergency room care have all been billed at progressively higher reimbursement codes, raising fees by billions of dollars. Many providers contend the shift is the result of sicker patients coupled with the
Recently, the CDC published the first national standards for prescribing opioids, new standards specifically dedicated to confronting this crisis. This set of guidelines will provide much greater leverage going forward when interacting with non-compliant providers, much as evidence-based guidelines have afforded crucial controls for assuring patients receive appropriate care. We are also starting to see some
I am sure all of you heard about the “ban” on large sugary drinks in New York City. I was very happy to see that a judge overruled it (Comrade Bloomberg will appeal that ruling). It was nice to see the judicial system play its proper role in controlling the expansion of government. This to
Medical inflation in workers’ compensation is back. This article in Managed Care Matters documents the trends that we have seen in our own data. Studies in IN, VA and NJ show significant increases. Facility and hospital costs are driving a lot of this increase. For those of you who do not know the trends in the industry,
America was founded and successful based on two principles. Liberty (or freedom) and opportunity. Actually, with pure and true liberty, opportunity is a given. Liberty was the primary basis of America at the onset. It was what made us great. Unfortunately, I believe the meaning and understanding of the word has been lost on most
The Food and Drug Administration rejected their own expert panel’s recommendation that medical doctors be required to have special training before they could prescribe long-acting narcotic painkillers that can lead to addiction. The AMA has fought this measure, saying it would be too burdensome for their members to be required to be trained before prescribing these drugs.