Wednesday, October 14, 2009, 10:40 PM - Political developmentsEvery injured worker and every reader of this blog has a lot at stake in the national healthcare debate. Failure of reform may destroy-for years- any chance of bettering the system.
Two ideas are colliding. The House appears to favor a public option. The Senate Finance Committee has cobbled together a smorgasbord of reforms to broaden coverage.
Where from here? The parliamentary maneuver known as "Reconciliation"?Sausage making in a House-Senate conference committee? More CBO analyses?
Amid all the facts and stats being slung about, let us pause and ask: what is worth fighting for?
It's a question asked by Jonathan Cohn in The New Republic. Cohn's arguments in "The Top Ten Things Worth Fighting For" summarize many of the important issues that are on the table. Check it out:
http://www.tnr.com/blog/the-treatment/t ... h-fighting
To those I'll add an eleventh: the anti-trust exemption of the health insurers, which dates back to the 1945 McCarran-Ferguson Act which provided anti-trust immunity, allowing states to regulate insurers. In many states there is little competition among health insurers. A small number of insurers have a huge national market share.
Here's a link to a New York Times piece by David Herzenhorn on this issue, which seems to be gaining increased scrutiny:
http://prescriptions.blogs.nytimes.com/ ... amp;st=cse
Monday, October 12, 2009, 11:47 AM - Medical treatment under WCThe Governor has signed AB 361.
AB 361, carried by Bonnie Lowenthal (D-Long Beach), prohibits an employer from refusing to pay for medical treatment if the employer authorized it before the service was rendered. Authorized treatments must be paid, even if the treater is not an MPN member. An employer can, however, withdraw or revise an authorization for treatments not yet provided.
Here's a link to the section:
http://leginfo.ca.gov/pub/09-10/bill/as ... rolled.pdf
The bill was introduced at the request of the California Chiropractic Association, whose member had experienced problems with refusal to pay for services that were authorized.
This caps the workers' comp bills for this session. Scroll down to read my posts on the bills the Governor has signed: Taneka's law, the predesignation bill, a bill to expand 4850 coverage, and a bill to require insurance coverage be posted online.
Monday, October 12, 2009, 10:31 AM - Political developmentsIn what will be a surprise to the conventional wisdom, Governor Schwarzenegger has signed SB 186, a bill which extends the right to predesignate a physician for workers' comp treatment.
Under the 2004 SB 899 reforms, the right to predesignate was scheduled to sunset at the end of 2009. SB 186, authored by State Senator Mark DeSaulnier (D-Concord), preserves the right to predesignate a physician before a work injury.
An analysis of the bill can be found here:
http://leginfo.ca.gov/pub/09-10/bill/se ... floor.html
The bill's text is here:
http://leginfo.ca.gov/pub/09-10/bill/se ... rolled.pdf
The predicted sunset of predesignation has been a source of unhappiness among many labor officials. Predesignation of a treating physician has been very popular with some workers. Although the issue may not have touched the vast majority of injured workers, the predicted demise of predesignation was seen as an unacceptable take-away to some.
In my experience, most workers haven't bothered to predesignate, even if they had the right to do so. Boxer and Gerson has many union clients, but even with a union clientele I still don't see that many workers who bother to predesignate.
Still, I would advise those who are eligible to do so. Otherwise, the employer can require the worker to select from an MPN list.
There had been rumors swirling that predesignation restoration would be a bargaining chip for other systemic changes, such as a revised PD schedule or or other medical cost containment moves. If any deal was struck, it's under the radar for the moment.
For those workers who are eligible to predesignate (note: the employer must offer non-occupational health insurance, so not all employees can predesignate) who wish to predesignate a physician, a form can be found here:
Workers who want to predesignate should look at the form carefully, since the statute contains a number of requirements that must be satisfied to have a valid predesignation. I'm aware that some employers have taken the position that only the DWC website form can be used. The statute does not say that. Some unions have dispatched workers to jobs with the predesignated doctor being indicated by filling in a stamp. But there are earlier versions of predesignation forms floating around which may not refer to all the elements that need to be satisfied for a valid predesignation. To my knowledge there has been little if any litigation at the WCAB over the validity of predesignation designations.
Monday, October 12, 2009, 08:19 AM - Political developmentsIt's rare to see Governor Schwarzenegger sign a bill that will give enhanced worker's compensation benefits.
But that's what AB 1227 does. Schwarzenegger signed the bill yesterday.
In 2008, Schwarzenegger vetoed a bill that had many similarities, AB 419.
Authored by Assemblyman Mike Feuer of Los Angeles, AB 1227 extends 4850 benefits to various classes of peace officers who were not previously covered by that section. Labor Code 4850 allows a leave of absence for up to a year maximum at full pay in lieu of temporary disability payments.
Here's the bill:
http://leginfo.ca.gov/pub/09-10/bill/as ... rolled.pdf
The bill clarifies who is eligible for 4850 benefits, which will now include Los Angeles Unified School District police officers, deputized local park rangers, community college police etc etc. Exempted are certain City and County of San Francisco personnel.
The bill was opposed by local government lobbyists who were concerned about increased state mandated costs.
Check my recent posts which cover the Governor's signing the Taneka's law bill, the predesignation bill, and the insurance coverage website bill.
Sunday, October 11, 2009, 10:05 PM - Political developmentsTaneka's Law has now ben signed by Governor Schwarzenegger.
The bill, AB 1093, will prohibit a "personal connection" defense to a workers' comp claim where the aggressor/assailant acts on the basis of beliefs regarding race, religious creed, color, national origin, age, gender, disability, sex or sexual orientation where the aggressor/assailant believes the victim to be a member of one of the protected classes.
Congratulations to Assemblywoman Mariko Yamada of Davis for carrying the bill. Working with Ms. Yamada on the bill was my colleague at Boxer & Gerson, Moira Stagliano. Ms. Stagliano represented the family of Taneka Talley, who was murdered at the Dollar Tree store in Fairfield when attacked on the basis of her race.
The employer denied the claim, asserting that it was non-compensable based on a claimed personal connection. The case was eventually settled, but not before a public relations furor ensued:
AB 1093 addresses this problem. It sends a message that the comp system will not tolerate claim denial based on the argument that a victim was selected because of their inherent racial or sexual characteristics.
It's good that the Governor saw this one clearly and signed the bill. It's been a lackluster year for workers' comp legislation. But with this signing, at least there's something positive worth noting.
Here is an analysis of the bill:
http://leginfo.ca.gov/pub/09-10/bill/as ... floor.html