News & Updates
MT WC OD Coverage Extended by Supreme Court
March 26th, 2012 Montana’s Workers’ Compensation Court and the Supreme Court have further expanded coverage under MT”s workers’ compensation laws. In Clarence Grande v Montana State Fund (DA 11-0492; Supreme Court 2012MT67), the courts have found that pre-existing illnesses and diseases may be covered under workers’ compensation OD if the leading cause of the “worsening” of the condition rather than the plain wording in statute that the workplace exposure must be the major contributing cause to the Occupational Disease. In a state with the highest costs in the United States, the courts have once again pushed their view of the law to a place where those high costs will be increased even further. Read the actual case from the Supreme Court @ http://wcc.dli.mt.gov/sccases/Grande_2012MT67.pdf
Joe Paduda To Present Webinar
March 26th, 2012 Narcotics in the workers’ compensation system has quickly become one of the highest priorities for many payers, providers and workers in the system. Joe Paduda is one of the industry commentators leading the way in opening up the mystery and secrecy behind the over prescription and useage of narcotics. Catch the webinar on March 28.
Montana’s Playing Field in WC is NOT Level
March 16th, 2012 The playing field is not level in Montana for WC Insurers. Montana State Fund pays no premium tax, (savings 3% – 6%), has immunity from punitive damages in any extra-contractual or third party bad faith claim, has no obligation to take any business from agents that have less than $300,000 in written WC premium (minimum level for which MSF will consider an agency appointment) forcing small accounts to apply direct (savings – 10% commission), and all of its workers are State of Montana workers, the only state workers that can receive performance and financial incentive bonuses. All this and yet MSF claims that they are the ‘insurer of last resort’, while actively competing against Plan 2 ‘for profit’ insurance companies for the ‘good business’.
Workers’ compensation fraud laws in Montana are another example of a playing field that is not level, Plan 2 insurers have the Dept of Insurance Fraud unit to investigate and prosecute potential fraud cases, Plan 3 Montana State Fund has it’s own internal unit of licensed peace officers who investigate and cooperate with the state Dept of Justice to prosecute suspected fraud cases…all funded with premium dollars via the State of Montana…Plan 1 organizations, self-insureds, have no such system nor immunity from actions arising out of investigation or prosecution of suspected fraud cases. Example of Plan 3 prosecuting a case that would not be available to a self-insured organization:
http://billingsgazette.com/news/state-and-regional/montana/article_f0402e8e-e627-54ba-806f-536faae1a673.html
Author/Blogger Argues that Obesity Isn’t as Unhealthy as Inactivity
March 1st, 2012 “Fitness in more important that fat.” Maggie Mahar argues a number of points that obesity alone is not solely responsible for increased disease and higher health care costs. Her point is that simple activity can go a long ways towards reducing illness and disease. Maggie Mahar is a notable health care policy blogger as well as the former Health Fellow at The Century Foundation where she was editor of HealthBeat. She is the author of “Money-Driven Medicine: The Real Reason Health Care Costs So Much” (Harper Collins 2006) http://reforminghealth.org/2012/02/28/obesity-fact-vs-fiction/
Physician Ranking Needed in Workers’ Compensation?
February 27th, 2012 February 27, 2012
A recent article seems to support the processes used for medical insurance to rate physicians and medical providers for implementation in the workers’ compensation claims process. Read the article here…