Category Archives: CA Workers Comp News

Phishing Scam Alert from CDC

PHISHING SCAM  – CDC Sponsored State Vaccination Program for H1N1

CDC has received reports of fraudulent emails (phishing) referencing a CDC sponsored State Vaccination Program for H1N1. The messages request that users create a personal H1N1 (swine flu) Vaccination Profile on the CDC.gov web site.

An example of the phishing email is below:
CDC phishing scam sample
Users that click on the embedded link in the email are at risk of having malicious code installed on their system. CDC reminds users to take the following steps to reduce the risk of being a victim of a phishing attack:
Do not open or respond to unsolicited email messages.
Do not click links embedded in emails from unknown senders.
Use caution when entering personal information online.
Update anti-virus, spyware, firewall, and anti-spam software regularly.

Experts Split on How Public Health Insurance Would Affect California

Experts Split on Public Health & California
Experts Split on Public Health & California

Although supporters of a government-run public health insurance option say the proposal could improve health care quality in California, others say the plan likely would have higher premium costs, the San Jose Mercury News reports.

Proponents

Supporters say California’s relatively limited health insurance marketplace could benefit from greater competition. Although the state currently has five major insurers, Anthem Blue Cross and Kaiser Permanente control about three-fifths of the state’s health insurance market, according to the American Medical Association.

Newly elected Rep. John Garamendi (D-Calif.), former California insurance commissioner, said a more competitive health insurance marketplace could motivate insurers to improve their business practices so they do not lose members to the public plan.

Lucien Wulsin — a health care attorney and director of the Santa Monica-based Insure the Uninsured Project — said a government-run plan also could experiment with different incentive models and spur innovation in the health care system.

Other experts note that California has a large pool of residents who might seek coverage under the public plan. The state currently has 6.8 million uninsured residents and 2.7 million residents who purchase coverage on the individual insurance market.

Skeptics

Other analysts say relatively few Californians would seek coverage under a government-run plan because it might have higher premiums than private health plans.

The Congressional Budget Office predicts that fewer than one million Californians would join the public plan. The office said the option is likely to attract less healthy residents, who could drive up overall premium costs.

Continue reading Experts Split on How Public Health Insurance Would Affect California

CA DWC Amended HCO Regulations Approved

New Amendents Get Go Ahead
New Amendents Get Go Ahead

Sacramento, CA (CompNewsNetwork) – The Division of Workers’ Compensation (DWC) has amended its regulations on health care organizations (HCOs) as another part of its 12-point plan to control medical costs in California’s workers’ compensation system.

The 12-point plan includes regulations recently enacted, regulations underway, and a set of proposals to be implemented in 2010. The revisions to the HCO regulations make HCOs more competitive with medical provider networks, providing a viable network option for workers’ compensation care. Studies have shown that network care is associated with lower costs for employers and better return to work outcomes for injured workers.
The final HCO regulations were filed with the secretary of state on Nov. 4, 2009 and become effective Jan. 1, 2010.  The revised regulations reduce HCO fees and eliminate duplicative HCO reporting requirements. The regulations, found in the California Code of Regulations, Title 8, sections 9771 through 9779.9, are authorized by Labor Code sections 133, 4600.3, 4600.5, 4600.7, 4603.5, and 5307.3.
The amendments include:
* The application for certification of an entity not licensed under the Knox-Keene Health Care Service Plan Act will be reduced from $20,000 to $2,500.
* The application for certification of an entity licensed under the Knox-Keene Health Care Service Plan Act will be reduced from $10,000 to $1,000.
* The recertification fee will be reduced from $10,000 to $1,000.
* The annual assessment fee will be reduced from $1.00 per enrollee to $250.00 for 0 to 1000 enrollees, $350 for 1001 to 5000 enrollees, and $500 for 5001 or more enrollees.
* The loan repayment surcharge in section 9779.5(a)(2) will be removed as the repayment period has now ended.
* The late payment fee in section 9779 will be repealed.
* Information collected by the Workers’ Compensation Information System (WCIS) will not be required to be resubmitted to DWC by HCOs.
The approved regulations, as filed with the secretary of state, can be found on the DWC Web site at http://www.dir.ca.gov/dwc/DWCPropRegs/hco/HCO_Regulations.htm.

CORPORATE WELLNESS CONFERENCE

Redesigning the Benefit Plan and changing employee behavior while promoting health and wellness

Get Wellness in L.A.
Get Wellness in L.A.

Central Coast IndustrialCare has no affiliation with this conference. It just looked like something that might be of interest to our readers.

With over 400 attendees and over 50 expert speakers, this high level corporate wellness conference will bring together the best healthcare leaders in the country for 2 days of intense advanced educational sessions and networking dedicated to corporate wellness, value based benefit design, and reducing healthcare costs through health and wellness promotion. The cost of healthcare for a single employee on average is $9,660 according to Towers Perrin and is increasing by at least 5% each year.

More and more employers are forced to cut costs and in some cases reduce staff or reduce benefits because of the downturn in the economy. To make matters worse many Americans are living unhealthy lifestyles and are not aware of wellness or prevention, which will only result in worse health conditions and higher healthcare costs in the future. Employers have reached an impasse where they need to do something drastic in order to continue offering affordable and meaningful healthcare benefits to their employees. The Corporate Wellness conference brings together employers, health plans, consultants and health insurance agents for advanced educational sessions by the leaders in corporate wellness and value based benefit design to teach you how to redesign benefit plan designs to focus on engaging the consumer and implementing the right tools, disease management, knowledge and health and wellness programs to really change employees actions and decisions with the end result being more affordable healthcare premiums and healthier employees.
Continue reading CORPORATE WELLNESS CONFERENCE

Will Work for Health

Get Paid to Stay Healthy!
Get Paid to Stay Healthy!

More Companies Are Paying Workers to Stay Healthy

If you’re like most people, you probably have a mile-long to-do list that includes items such as “Get blood pressure and cholesterol checked” and “Start walking 20 minutes per day.” Who knows when you’ll get around to all that? But if your employer offered to pay you cold, hard cash for taking better care of yourself, you’d probably start right now.

At least, that’s one finding of a new study by human-resources consultant Watson Wyatt and a nonprofit outfit called the National Business Group on Health (NBGH). Bent on slashing costs left and right these days, a growing number of big companies are nonetheless investing serious money in bribing, er, encouraging employees to get healthier. Nearly 6 in 10 (58%) now offer wellness programs, up from fewer than half (43%) in 2007. And the percentage of companies paying people to ditch bad habits (especially eating junk food and not exercising enough) has gone from 53% in 2008 to 61% this year. (See pictures of cubicle designs submitted to The Office.)

That trend seems likely to continue. Another survey, by employee-benefits experts Towers Perrin, says that among employers who don’t yet have programs in place, 33% plan to start one and 23% say they will introduce or increase financial rewards for their employees who get off the couch and snack on peaches instead of pizza. Smart. Notes the Watson Wyatt–NBGH study: “Companies that offer financial incentives report significantly higher participation in wellness programs.” It’s the old adage in action: What gets rewarded gets done.

Continue reading Will Work for Health

Fall Down Go Boom, Still #1

Falling Still the #1 Injury
Falling on ASSE list

Workplace Safety Addressed with Fall Reduction Standards by ASSE

Republished with permission from ReduceYourWorkersComp.com

As slips, trips and falls continue to represent significant exposures and hazards driving costs up in the workplace, the ASSE announced the approval of three new fall protection standards by the American National Standards Institute (ANSI), aimed at preventing these workplace hazards.

Of the 5,657 fatal on-the-job injuries occurring in 2007, 847 were attributed to falls according to the Bureau of Labor Statistics (BLS)

The ASSE standards (effective November 16, 2009) aimed at preventing injuries and death due to falls are:

1.  “Specification and Design Requirements for Active Fall Protection Systems” (ANSI/ASSE Z359.6-2009).
Specifies requirements for the design and performance of complete active fall-protection systems, including travel-restraint and vertical horizontal fall-arrest systems.
2.  “Connecting Components for Personal Fall Arrest Systems” (ANSI/ASSE Z359.12-2009).
Establishes requirements for the performance, design, marking, qualification, test methods and removal from service connectors.
3.  “Personal Energy Absorbers and Energy Absorbing Lanyards” (ANSI/ASSE Z359.13-2009).
Requires all energy-absorbing lanyards and personal energy absorbers to reduce the forces implied on the user to less than 10 times the normal gravitational pull of the earth. In addition, users of energy absorbing lanyards must weigh within the range of 130 to 310 pounds (59 – 140 kg).
Continue reading Fall Down Go Boom, Still #1

The Heat is Still On!

Hot sun photo from NASA
Hot sun photo from NASA

Since the current heat wave began on July 11, Cal/OSHA has conducted 167 inspections of outdoor workplaces identifying over 200 violations while checking for compliance to the heat illness prevention regulations. Gaining compliance from employers is the goal to successfully reducing the number of illnesses and fatalities for all outdoor workers across the state.

“Our increased enforcement and outreach efforts demonstrate the commitment we have to ensuring the safety and health of California workers,” said Department of Industrial Relations Director John C. Duncan.  “We are also working with industry, community, and labor groups to educate employers and the public so they understand how to comply with the nation’s first regulation to protect workers from heat-related illnesses and deaths.”
Cal/OSHA continues to conduct targeted enforcement efforts, especially during periods of high heat.  This year so far a total of 1,702 inspections have been conducted to enforce compliance with heat illness prevention regulations and 472 violations of regulations have been documented with a total of $415,398 in penalties assessed.
READ FULL ARTICLE from CompNewsNetwork:

Qualified Medical Evaluator Forms In Spanish

The Division of Workers’ Compensation (DWC) has posted on its Web site a Spanish-language version of the qualified medical evaluator (QME) panel request form for unrepresented employees, including instructions on how to use Form 105 at:
http://www.dir.ca.gov/dwc/FORMS/QMEForms/QMEForm105Spanish.pdf

Additionally, an example with Spanish language instructions on how to complete the Employee’s Permanent Disability Questionnaire (DWC-AD Form 100 [DEU]) can be found here.

The forms can be downloaded or printed from the DWC Web site at no charge and are in Spanish. However, the user is directed to complete the answers on the forms in English.
The division is hopeful that the Spanish-language versions of these forms will make the QME process easier to understand for injured workers and employers who are primarily Spanish-speaking.

Expensive Paperwork

Paperwork is driving up health care costs by as much as $9 billion annually in California, according to a public interest group that suggests physicians and insurers spend way too much time on processing insurance claims.

In California, physicians typically spend about 45 minutes a day on insurance paperwork, according to a report released Thursday by the California Public Interest Research Group.

“If we can do it more cheaply, it’s a win-win for everybody,” said Michael Russo, a health care advocate and staff attorney with CalPIRG. “When costs are skyrocketing, it’s best to go for the low-hanging fruit. This is an area where we spend a lot of money.”

In all, CalPIRG estimates that $9 billion is spent by insurers and medical practices in California to process insurance claims.

“It’s just ridiculous,” said Dr. David Kosh, a family physician in Sacramento. He said his billing staff spends most of its day on the phone with insurers.

Source:: Bobby Caina Calvan | The Sacramento Bee

To read the complete article, visit www.sacbee.com.

Hello world!

When we launched our eLetter, “Central Coast Industrial Care News,” last May we didn’t anticipate how much news, discussion and employer resources that our subscribers would find useful. A lot more than we could fit into a monthly newsletter … at least more than most would want to scroll through onscreen!

That’s what inspired us to launch this blog; to include more of the information about Workers’ Comp as it relates to California employers. And as a place where you can share your opionions and ideas with your fellow emloyers in the Santa Maria Valley.

Who would have predicted even a year ago that health care would be daily front page news? Please comment with any suggestions or specific questions you have about occupational medicine and our services.

Thanks for looking and stay tuned as we will add content several times per week.