Monday, October 19, 2009, 10:58 PM - Political developmentsOne thing many comp stakeholders can agree on is that far too many employers are skirting the legal requirement that they be covered for workers comp.
Employer fraud by scofflaw employers who seek to avoid paying comp premiums has been a growing problem. Those employers gain an unfair competitive advantage. And they may be forcing employees to seek medical treatment at public facilities, burdening the taxpayer.
Here's a link to my post "It's the Employer Fraud, Stupid":
http://workerscompzone.com/index.php?en ... 818-110358
That's why it's heartening to see that SB 313 has passed the California Senate and is on its way to Governor Schwarzenegger.
SB 313 would increase penalties against employers who fail to secure comp insurance. Employers without insurance would be liable for the greater of 2 times what their premium per employee would have been or per-employee penalties of $1500, going back as much as 3 years.
Thanks are due to Sate Senator Mark DeSaulnier for his work on the bill. Also deserving recognition is Scott Hauge of Small Business California, the bill's primary sponsor.
It would seem likely that the Governor will sign this one. Let's hope so.
Here's a link to the bill:
http://www.leginfo.ca.gov/pub/09-10/bil ... rolled.pdf
Saturday, October 17, 2009, 09:53 AM - Political developmentsA state where employers are required to provide insurance to employees who work over 20 hours per week....
A state whose healthcare premiums are (along with North Dakota) the
lowest in the nation......
A state whose Medicare costs per beneficiary are the lowest per Medicare
beneficiary in the country.....
A state that is at the top in life expectancy charts....
A state where 90% of the population has health insurance.....
A state where per capita visits to emergency rooms are low....
A state that is already making progress on going digital with its healthcare system.....
That would be the Aloha state.
It's tempting to assume that a moderate climate, a lower stress environment, and an emphasis on healthy lifestyles is part of the picture.
But it also appears that the near universal coverage and the matrix of physician/hospital availability play a role as well.
It's another reminder to my friends on the left that a "public option" is not the only game in town. Unfortunately for the "public option", President Obama has not been a great communicator. The President has barely lifted a finger in support of that concept. This apparent risk-averse strategy is causing many folks to get quite impatient:
While I personally favor a "public option", the Aloha state experience may offer some ideas.
Here's my earlier piece on "Wanna Go Dutch?":
http://workerscompzone.com/index.php?m= ... 001-220224
Check out this piece in the New York Times on Hawaii's system:
http://www.nytimes.com/2009/10/17/healt ... amp;st=cse
Wednesday, October 14, 2009, 10:40 PM - Political developmentsEvery injured worker and every reader of this blog has a lot at stake in the national healthcare debate. Failure of reform may destroy-for years- any chance of bettering the system.
Two ideas are colliding. The House appears to favor a public option. The Senate Finance Committee has cobbled together a smorgasbord of reforms to broaden coverage.
Where from here? The parliamentary maneuver known as "Reconciliation"?Sausage making in a House-Senate conference committee? More CBO analyses?
Amid all the facts and stats being slung about, let us pause and ask: what is worth fighting for?
It's a question asked by Jonathan Cohn in The New Republic. Cohn's arguments in "The Top Ten Things Worth Fighting For" summarize many of the important issues that are on the table. Check it out:
http://www.tnr.com/blog/the-treatment/t ... h-fighting
To those I'll add an eleventh: the anti-trust exemption of the health insurers, which dates back to the 1945 McCarran-Ferguson Act which provided anti-trust immunity, allowing states to regulate insurers. In many states there is little competition among health insurers. A small number of insurers have a huge national market share.
Here's a link to a New York Times piece by David Herzenhorn on this issue, which seems to be gaining increased scrutiny:
http://prescriptions.blogs.nytimes.com/ ... amp;st=cse
Monday, October 12, 2009, 11:47 AM - Medical treatment under WCThe Governor has signed AB 361.
AB 361, carried by Bonnie Lowenthal (D-Long Beach), prohibits an employer from refusing to pay for medical treatment if the employer authorized it before the service was rendered. Authorized treatments must be paid, even if the treater is not an MPN member. An employer can, however, withdraw or revise an authorization for treatments not yet provided.
Here's a link to the section:
http://leginfo.ca.gov/pub/09-10/bill/as ... rolled.pdf
The bill was introduced at the request of the California Chiropractic Association, whose member had experienced problems with refusal to pay for services that were authorized.
This caps the workers' comp bills for this session. Scroll down to read my posts on the bills the Governor has signed: Taneka's law, the predesignation bill, a bill to expand 4850 coverage, and a bill to require insurance coverage be posted online.
Monday, October 12, 2009, 10:31 AM - Political developmentsIn what will be a surprise to the conventional wisdom, Governor Schwarzenegger has signed SB 186, a bill which extends the right to predesignate a physician for workers' comp treatment.
Under the 2004 SB 899 reforms, the right to predesignate was scheduled to sunset at the end of 2009. SB 186, authored by State Senator Mark DeSaulnier (D-Concord), preserves the right to predesignate a physician before a work injury.
An analysis of the bill can be found here:
http://leginfo.ca.gov/pub/09-10/bill/se ... floor.html
The bill's text is here:
http://leginfo.ca.gov/pub/09-10/bill/se ... rolled.pdf
The predicted sunset of predesignation has been a source of unhappiness among many labor officials. Predesignation of a treating physician has been very popular with some workers. Although the issue may not have touched the vast majority of injured workers, the predicted demise of predesignation was seen as an unacceptable take-away to some.
In my experience, most workers haven't bothered to predesignate, even if they had the right to do so. Boxer and Gerson has many union clients, but even with a union clientele I still don't see that many workers who bother to predesignate.
Still, I would advise those who are eligible to do so. Otherwise, the employer can require the worker to select from an MPN list.
There had been rumors swirling that predesignation restoration would be a bargaining chip for other systemic changes, such as a revised PD schedule or or other medical cost containment moves. If any deal was struck, it's under the radar for the moment.
For those workers who are eligible to predesignate (note: the employer must offer non-occupational health insurance, so not all employees can predesignate) who wish to predesignate a physician, a form can be found here:
Workers who want to predesignate should look at the form carefully, since the statute contains a number of requirements that must be satisfied to have a valid predesignation. I'm aware that some employers have taken the position that only the DWC website form can be used. The statute does not say that. Some unions have dispatched workers to jobs with the predesignated doctor being indicated by filling in a stamp. But there are earlier versions of predesignation forms floating around which may not refer to all the elements that need to be satisfied for a valid predesignation. To my knowledge there has been little if any litigation at the WCAB over the validity of predesignation designations.