Medical

Effective Communication with Physicians

by Jennifer M. Smith, Esq.

We recently gave a presentation on how to effectively communicate with physicians. Because medical opinions are the cornerstone of most workers’ compensation cases, we wanted to share the suggestions with all of our clients. So often, adjusters and employers have good information, perhaps from surveillance, prior medical records or details from […]

Tuesday, February 14, 2017|

The Painful Problem of Opioid Addiction: Although Still a Problem, Improvement Seen in Georgia

by Frank A. Wasser, Esq.

Another prominent topic at the seminar, and certainly one we have reported on frequently in the past few years, is the opioid drug epidemic and its impact in workers’ compensation cases. Despite the increase in opioid use and abuse nationwide, there is some evidence that opioid use among Georgia’s workers’ compensation […]

Wednesday, October 26, 2016|

Georgia’s Crackdown on Physician-Dispensed Prescriptions Barely Effective in Reducing Costs

by Samantha J. Bily, Esq.

In 2011, Georgia capped the reimbursement rate for physician-dispensed prescriptions to the average wholesale price to address payors’ concerns with high prices associated with physician-dispensed medications, which often cost 30% more than pharmacy-dispensed prescriptions. While the reform led to an initial decrease in costs, a recent study by the Workers’ Compensation […]

Tuesday, August 9, 2016|

Genetic Testing to Determine Which Medication Is Best? Maybe

by Vincent A. Toreno, Esq.

We are seeing a rising trend in requests for authorization of “one-time” genetic testing. Healthcare providers are requesting the testing to assist in effectively prescribing medications for the injured employee, claiming the tests help pinpoint the most beneficial medications with the least side effects as well as appropriate dosages and addiction […]

Tuesday, April 12, 2016|

REMINDER: New Case Management Rule Became Effective January 1, 2016

by Alissa C. Atkins, Esq.

The State Board revised Rule 200.2 regarding medical case management, and the changes became effective last month. The revision was prompted by the McRae case, which pertained to contact of authorized treating physicians by defense counsel. However, as a result of reviewing all issues pertaining to medical case management and contacting […]

Tuesday, February 9, 2016|

New Deadlines to the Conditional Payment Recovery Process by CMS: 30 Days to Dispute Charges, 60 Days to Pay

by William A. Green, Esq.

The Center for Medicare and Medicaid Services (CMS) recently announced major changes to the conditional payment recovery process. The most significant change involves a 30-day deadline to dispute charges.

Effective October 5, 2015, once a Conditional Payment Notice is issued, workers’ compensation insurance carriers will have 30 days from the date […]

Tuesday, November 10, 2015|

The Fight Over Off-Label Use Continues

by Timothy A. Raimey, Jr., Esq.

Recent lawsuits against pharmaceutical companies alleging they are marketing powerful cancer treatment drugs for use in treating non-cancer pain have had mixed results. Pharmaceutical companies rejoiced after a 3rd Circuit Court of Appeals decision affirmed dismissal of a lawsuit against the makers of Actiq and Fentora, two powerful narcotics designed […]

Tuesday, October 13, 2015|

Compensability of Inexplicable Paralysis, Blindness, or Other Neurological Symptoms

by Samantha J. Bily, Esq.

If a claimant is suspected of having conversion disorder, is it compensable? Both the legal and medical community are grappling with this issue.

First, what is conversion disorder? Imagine an employee suffers a compensable injury to his right shoulder. He undergoes surgery, after which he contends he is completely […]

Tuesday, October 13, 2015|

The Compound Cream “Rabbit Hole”

by Timothy A. Raimey, Jr., Esq.

Prescriptions for compound creams have become increasingly popular for pain management treatment in workers’ compensation claims. These medications can be extremely costly, and in some instances, ineffective for their intended use. We recently spoke with Mark Pew, Senior Vice President at PRIUM, a utilization review company, regarding effective management of […]

Tuesday, September 8, 2015|

Drug Free Workplace: Get Certified and Receive a 7.5% Discount in Work Comp Premiums

by Jennifer M. Smith, Esq.

Employers, are worker’s compensation premiums continuing to cut into your bottom line? One way to reduce those costs is to become a certified drug-free workplace. The Georgia State Board of Worker’s Compensation certifies employers as drug-free. Once certified, those employers submit a copy of their drug-free workplace certificate to their insurance […]

Tuesday, August 11, 2015|
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