CA DWC Adjusts DMEPOS Of Medical Fee Schedule

Oakland, CA – 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 by Labor Code section 5307.1.

The order adopts two Medicare DMEPOS updates.

  • The update includes all changes identified in Center for Medicare and Medicaid Services Change Request (CR) number 7416 which is effective for services rendered on or after July 1, 2011.
  • The update includes all changes identified in JSM/TDL-11098 effective for services rendered on or after Jan. 1, 2011. This file updates three codes, which were not included in the January file: L3660, L3670, L3675.

Can vitamin D lower your risk of melanoma?

letter D made with vegetables
Big D fights the Big C

 

By Genevra Pittman
NEW YORK | Mon Jun 27, 2011 5:32pm EDT

(Reuters Health) – Taking vitamin D may help protect women who have already had non-melanoma skin cancers against a much deadlier form of the disease, suggests a new study.

But researchers caution that the results need to be confirmed with further studies, given that the number of women in their study who got melanoma – the most dangerous type of skin cancer – was low to begin with.

“We’re not recommending super high doses” of vitamin D, study author Dr. Jean Tang, from Stanford University School of Medicine in Redwood City, California, told Reuters Health.

However, she added, “I feel good about saying if you’ve already had a non-melanoma skin cancer, you’re already at risk for developing melanoma in the future, (and) taking a little bit of calcium and vitamin D, while other studies need to be done, seems reasonable and not harmful.”

Some evidence has suggested that vitamin D might help protect against skin cancer and other cancers by influencing cell growth, and perhaps stopping cells from turning into cancer cells, researchers explained.

Continue reading Can vitamin D lower your risk of melanoma?

California DWC Launches JET File!

photo of a California Deptarment of Workers' Compensation jet aircraft
Get me to court on time!

The Division of Workers’ Compensation debuts a new fast, flexible and reliable electronic filing option for the workers’ compensation courts called, “JET File.” Designed and built in conjunction with external users for those annually filing 100 or more of any one of the six most common court forms, JET File offers many advantages for claims administrators, representatives, lien claimants and self-insured employers. JET File will also produce a broader impact on the workers’ compensation courts by reducing the amount of paper received at the division’s 24 district offices.

“It is important to encourage more participation in electronic filing as a way to improve the efficiency of EAMS and the service we provide,” said Christine Baker, acting director of the Department of Industrial Relations. “In talking with our constituents and stakeholders, it was clear that we had the same goals, and these mutual interests resulted in working together to make JET File a reality.”

DWC has built the receiving end of this new filing option and large filers can now decide how to connect to it by choosing one of three JET streams:

  • JET stream 1: Use vendor developed software. In this stream filers purchase software from an authorized vendor and use that software to JET File directly
  • JET stream 2: Use the services of a third party filer. In this stream filers use the services an authorized third party filer (TPF) who files on their behalf
  • JET stream 3: Create their own JET stream using technical specifications posted on the DWC Web site. Users of this stream create their own JET Filing mechanism so they don’t need to buy software or use a TPF. This is for the tech savvy entities that want maximum control of their filings.

In addition to breaking the paper barrier by eliminating associated wait times and costs, benefits for JET Filers include:

  • Ability to submit one or many documents in a single transmission
  • Receive electronic response of success or errors
  • Receive case number electronically upon successful submission of an application
  • Holds and reprocesses DORs for up to 15 days to get a court date
  • Use OCR forms or e-forms (if in the e-forms trial) as needed.

Continue reading California DWC Launches JET File!

OSHA To Kick Off Young Worker Safety Day Campaign

little girl with clipboard wearing hard hat with clipboardThe U.S. Department of Labor’s Occupational Safety and Health Administration will partner with the CareerSafe Online program to help kick off the National Young Worker Safety Day campaign Tuesday, June 21, 10 a.m. CDT, at the SkillsUSA National Leadership and Skills Conference in Kansas City.

“OSHA is partnering in this campaign to make a significant and critical impact to decrease the number of youth worker injuries and fatalities in our country,” said OSHA Assistant Secretary Dr. David Michaels. “Every five days, one teen worker is killed on the job, and more than 200,000 young workers are injured yearly – numbers that are double and sometimes triple that for any other age category.”

The SkillsUSA conference will host more than 5,600 high school and college students from across the country, who will have the opportunity to join the campaign, sign safety awareness pledges, participate in safety awareness activities and receive materials to help keep safety at the forefront both inside and outside their work environments. More information on the conference is available at http://www.skillsusa.org/events/nlsc.shtml.

The goal of the CareerSafe Online program is to teach younger workers how to stay safe in the workplace, and help prepare them for a safe and prosperous future in their chosen careers.

Members of the public with questions about the campaign can contact Andrea Foster Mack from CareerSafe Online at afoster@careersaseonline.com or by telephone 979-574-5715

California Workers’ Compensation Payers Need to Take Immediate Action To Address New Medical Bill Data Capture Rule

Woman in panic holding an alarm clockCONCORD, Calif., June 16, 2011 /PRNewswire

Jopari Solutions, Inc., a leading supplier of Workers’ Compensation and Auto Medical eBilling and ePayment products, explained today that the impact of the October 15, 2011 deadline under the state’s recently released Electronic and Standardized Billing Regulations may not be fully understood by California workers’ compensation payers.  On and after that date, all medical bills must conform to a set of well-defined coding and billing standards.

According to Jopari, because the new California rules do not set forth any waiver provision for delayed implementation criteria, payers failing to comply with the October 15, 2011 paper bill requirements will be subject to Audit exposure and related fines and penalties.  Said Steve Stevens, CEO of Jopari, “Our intention in pointing this out is to ensure that payers are focusing on the dual implementation dates these new regulations have presented the industry. Many payers we have been in contact with have primarily been focused on October, 2012 when the eBill requirements go into effect, while in fact, many of the eBill implementation requirements needs to be done by October 15 of this year.”

Mr. Stevens explained, “Workflows, data capture, and reporting systems will need to be changed, without exception.”

Jopari elaborated on the most pressing of the factors payers should consider in light of California’s new rules:

Payers are required to determine if a submitted bill meets all standard bill criteria; and must reject or accept the bill based on the criteria
Payers must make payment within 45 days (60 days if governmental entity) of receipt of properly completed bills or be subjected to self-imposed 15% penalties and 10% interest.
New data elements are required to be captured by Payers, and must be included in state reporting so as to provide this specific new data under WCIS reporting requirements

Jopari advocates that payers not wait for October 2012, but proceed to implement eBilling immediately. In an eBill environment, these new criteria are evaluated electronically, and a definitive audit trail is established.

“Early implementation of eBilling eliminates financial and human asset stresses associated with a two-tier paper and electronic compliance management approach.  Equally important, pro-active acquisition of eBilling acceptance capabilities will allow payers to hone their workflows and processes, and, in many cases, create competitively differentiating service offerings for knowledgeable California employers who are aware of the new rules,” added Mr. Stevens.

Jopari provides eBilling processing nationwide for a number of the largest workers’ compensation payers in the marketplace and manages integration and services agreements with some of the largest and most important technology vendors for providers.

How Surfing Is Helping to Heal Wounded Warriors

Healing through surfing photo and logo
Surf's up and helping our war heroes

 

By Karlie Pouliot

To the outside world, it looked like Jimmy Miller had it all. He was a competitive surfer living in a beach community in California; he was a world traveler and was even married to a supermodel. In his brother’s words – he had it all going on.

“He lived the ideal life,” Jeff Miller told FoxNews.com. “He had tons of friends, not just locally, but all over the world. For all intensive purposes, he was a pretty happy guy.”

But around Jimmy’s 35th birthday, everything started to change when he sustained a shoulder injury that took him out of the water.

“It went from something is a little strange to ‘Wow, we need to find some help for him,’ to he’s in an institution, and he’s getting better,” Miller said.

But Jimmy never did recover and he ended up taking his life in August 2005.

The Jimmy Miller Memorial Foundation is a non-profit organization honoring the life of Jim Miller. On the foundation’s website, they describe Jim as “a teacher, lifeguard, a dreamer, a traveler, a friend, and a worldwide ambassador of fun times and good surf.”

Continue reading How Surfing Is Helping to Heal Wounded Warriors

Top 5 Ways To Push Your Injured Workers to Attorneys

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Free initial consultation!

As long as there are workers compensation claims and ways for attorneys to make money from workers comp claims, attorneys will be involved in the processing of some of these claims. There will always be employees enticed by television commercials with the attorney holding fistfuls of money and saying, “Call me. I will make you rich.” or words to that effect.

To significantly reduce the number of employees hiring an attorney avoid making these five mistakes driving an employee into the arms of a waiting workers comp attorney.

1. Failing to Provide Immediate Medical Care
Being lazy about providing medical care to the injured employee is one of the biggest mistakes an employer makes when an employee is hurt. When an unknowing or untrained supervisor does not want to bother with the workers comp claim and tells the employee to “give it a few days,” it is almost a guarantee the employee is going to hire an attorney.

Think! – The employee is in pain, medical care is not being provided, the employee’s attitude quickly becomes “they don’t care about me” which quickly switches to “I don’t care about them either.” The only remaining question for the employee is whether to go to a doctor on their own or not. To answer that question they turn to the Internet/TV attorney or the yellow pages attorney. Keep in mind these cases are taken on contingency so the injured worker does not have to come up with a retainer for attorney fees. If the employee “wins” the case, the employer pays the attorney.

The solution – Everyone in the company, including employees, should know immediate medical care is to be provided on all work-related injuries. Every supervisor and manager must ensure medical care is provided immediately upon learning an injury occurred. Of course, if your company used nurse triage, this would go a long way toward allevaiting this issue because employees would call the triage nurse immediately.
Continue reading Top 5 Ways To Push Your Injured Workers to Attorneys