Insight, analysis & opinion from Joe Paduda
From the world of workers comp comes a crystal clear picture of what’s wrong with America’s health care system, and how difficult it will be to get it right. WorkCompCentral has a piece this morning about California’s proposal to not … Continue reading Why health reform will be so tough
Read More...Dave North, CEO of Sedgwick CMS was one of the morning panelists. He began with a rather strong statement about workers comp, a statement that was also an indictment of the industry’s complete inability to manage medical – the fact … Continue reading WCRI – Medical costs are up because solutions don’t work
Read More...If you’ve been wondering why your company is paying so much for high-powered pain medications, here’s why. Cephalon, manufacturer of Actiq and Fentora, has: “agreed to plead guilty to promoting off label use of its painkiller Actiq–which was widely used … Continue reading Cephalon – the worst of the worst
Read More...Health care costs are higher because of waste fraud and abuse. How much higher is a subject of debate, but common wisdom suspects we’re paying hundreds of billions more each year than we should. There are big frauds and abuses … Continue reading The small frauds
Read More...Surgical devices left inside a patient. Dispensing the wrong medication or the wrong dosage. Giving a patient the wrong blood type in a transfusion. Serious pressure ulcers incurred while hospitalized. Infections from catheterization in the ICU. These are among the … Continue reading Why is workers comp paying for hospital errors?
Read More...New York announced significant (some would say drastic) changes to the state’s WC Laws and Regulations last summer. These changes will result in a dramatic decrease in WC premium rates in the state, something long overdue, and much welcomed. There … Continue reading The latest on NY’s WC Rx changes
Read More...The regulators in NY have decided that drugs for work comp claims will be reimbursed at the Medicaid fee schedule plus a dispensing fee. That is a huge change from the prior reimbursement level of usual and customary, which in … Continue reading NY’s new WC Rx fee schedule
Read More...My post on the efforts by WCPA and others to roll back parts of the NY workers comp reforms has generated a lot of criticism by individuals who appear to consider themselves advocates for the injured worker. My motives, intelligence, … Continue reading PBMs and retail pharmacies
Read More...If you want to know why you are getting more physician bills with meds on them, it’s simple – physician dispensing generates big profits.
Read More...The two major third party billers have been on the block for a few months. The first round of queries went out to financial buyers and lately they’ve opened the process up to potential strategic buyers as well. Why?
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