Bypassing Pharmacies Boosts Prescription Costs And Other Top News Tidbits

(Edited by The Insurance 411)

Bypassing pharmacies boosts workers’ comp prescription costs in Pa.

Nearly half of what Pennsylvania’s workers’ compensation program pays for prescription drugs goes to physicians who dispense them directly to patients, bypassing pharmacies, a lucrative practice that is limited by many states and not reimbursed at all by private insurance, Medicare or Medicaid, according to a new report. Although few doctors take advantage of the loophole, the cost differential can be enormous. A single Percocet cost an average 64 cents at a pharmacy last year, the Workers Compensation Research Institute reported Monday, vs. $3.55 when dispensed by a physician. Patients typically don’t know the difference; there are no copays in workers’ comp, which is funded by businesses. Read more…

The post Bypassing Pharmacies Boosts Prescription Costs And Other Top News Tidbits appeared first on Work Comp Roundup.

 

Industry Bloggers Debate Effectiveness of Workers’ Compensation

Is the workers’ compensation system still a grand bargain for employers and injured employees? Industry bloggers gathered at The California Workers’ Comp & Risk Conference in Dana Point to answer this question with an overwhelming “NO!”

The panel featured Mark Walls from Safety National and the Work Comp Analysis Group, David DePaolo from WorkCompCentral.com, Dale Debber from Providence Publications, plaintiff attorney Robert G. Rassp and Rebecca Shafer from Amaxx Risk Solutions. Read more…

 

Litigation Surrounding Driver Fatigue

According to the National Highway Traffic Safety Administration, truck driver fatigue is a contributing factor in as many as 30-40% of all crashes involving heavy trucks.  Join Ringler Radio host, Larry Cohen, co-host, John Muir, Jr., Esq., and special guest, Attorney David A. Brose, from the firm Langdon & Emison, as they talk about truck driver fatigue, litigation stemming from these incidents, and what is being done to prevent truck driver fatigue.  Listen

NCCI Examines Medicare Set-Asides (MSAs) and Workers Compensation

On September 15, 2014 NCCI published an important report that took an in-depth look at the demographics and the review process as they relate to Workers’ Compensation Medicare Set Asides.  Utilizing data supplied by Gould & Lamb, the research looked at a sample of proposed workers’ compensation settlements that had been reviewed by the Centers for Medicare & Medicaid Services (CMS).  Some of the findings include:

1. About 65% of Medicare-eligible claimants are under age 65.
2. 60% of the settlements reviewed by CMS exceed $100,000.
3. Half of the submissions reviewed by CMS have proposed MSA amounts of less than $25,000.
4. 40% of proposed total settlement costs are to fund and support MSAs.
5. Half of the MSA settlement amount is a result of prescription drugs.
6. CMS’ processing time of MSAs has begun to decrease.

To learn more about the findings in the 28 page study, visit the NCCI website.