by Christopher N. Kleps, Esq.

In February, a California hospital owner pleaded guilty to charges related to a kickback scheme in which he paid doctors and other providers who referred patients to his clinic for surgery. The facility was estimated to have earned $500,000,000 from those referrals, many of which were for patients who could have treated at more convenient facilities closer to their homes. The owner also agreed to testify against a state senator he allegedly bribed to block legislation that would have slowed or stopped the owner’s scheme. This news should serve as a reminder of two important issues for employers and insurers. First, this serves to highlight the value of independent medical examinations, double-checking of referrals, and conferences with doctors. The second is the importance of legislation. The owner’s scheme was aided by a quirk in California law related to how hospitals could bill workers’ compensation insurers.

Knowing the status of current and pending legislation in your state can help you plan how to counteract such legislative quirks before they adversely affect your business. Fortunately, there are no similar allowances in the Georgia Code, and furthermore, no new workers’ compensation bills were introduced in the Georgia General Assembly this year. Although the legislature is still in session, the time has already passed for any proposed changes to the Workers’ Compensation Act. Therefore, the current version of the Code will remain in effect when other laws change in July.