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Nov
11

The buzz from the comp conference

There’s a lot more happening in Vegas than we can discuss here, as many of my conversations yesterday started with the words “you can’t write about this”.
Alas.
There was much discussion about Texas and the demise of the voluntary networks on the first of the year. While PBMs have been working thus for over a year, other vendors are only now becoming aware of the implications.
While the Certified networks will continue, most of the work comp medical care doesnt flow thru them. Payers have long relied on an assortment of broad-based generalist PPOs, specialty networks and PBMs to help reduce medical expense. Come 1/1/11, those vendors are out of business.
Word is employers are livid, as are several powerful members of the Texas legislature who are none too pleased with work comp Commissioner Bordelon. The Commissioner is in a very tough spot as the interpretation of the enabling legislation sunsetting the voluntary networks is pretty straightforward.
Word of a couple of deals is circulating on the floor; one’s big – quite big, and the other not. No word on timing of the announcement but both will likely occur.
I’ve been asked a dozen times about the current status of AHCS’ suit against me. Here’s the update.
Our lawyers met last week to set the discovery and process schedule. More on that when I catch up with my attorneys – who are very very good, thank you.
I can’t reveal our legal strategy but suffice it to say we (me, supporters, and our attorneys) are not cowed by AHCS or their bullying tactics.
And yes, there is a legal defense fund in the works; expect an announcement soon.
I’d be remiss if I didn’t offer a big ‘thank you’ to all the folks who voiced their support and offered help. I’ll need both if we are going to successfully expose AHCS and their business practices.
More to come…


Joe Paduda is the principal of Health Strategy Associates

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A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

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