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Nov
18

Today’s work comp briefs…

And, no, I’m NOT referring to the type Bob Wilson discusses in a recent investigative report...

First up, and timely indeed, is a post from friend and colleague Sandy Blunt about the integration of guidelines with medical bill review. Medata ran a large sample of medical bills from a very well managed work comp payer against medical guidelines and identified “15 percent in cost savings from questioned medical procedures” – over and above what the payer was already finding.  Now, I’d note that “questioned” does not mean “actual”, nor should it.  However, it does indicate a major opportunity that I daresay many payers are missing out on; employing guidelines as part of the bill review process.

Compounding drugs isn’t just for people anymore!  A colleague sent me a link to a story of a drug dealer in Texas that has been selling performance-enhancing drugs for racing horses. Good to know they aren’t limiting their expertise to just us humans!

Millennium Labs and Texas Mutual just inked a deal wherein Millennim will be providing drug testing services for claimants prescribed opioids. (ML is an HSA consulting client).  Texas Mutual has been at the forefront of opioid management for a couple years now; this further enhances their program.

The Claims and Litigation Management Alliance is hosting what looks to be an interesting conference in January; the NYTimes’ Barry Meier will be keynoting; Barry has written several books on opioids and published articles on physician dispensing and opioid usage in work comp


One thought on “Today’s work comp briefs…”

  1. Agreed as always Joe! Working in the Ancillary Service sector of the work comp industry I can whole heartedly say that Texas Mutual is one of the best I’ve seen in managing claims based on guidelines and objective data. Hats off to them for continuing this trend by utilizing a well known and trusted tactic to fight the illegal trade of opiates and ensuring patient compliance for highly addictive meds. I would hope that more payers would follow suit.

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Joe Paduda is the principal of Health Strategy Associates

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