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Includes: current situation in Minnesota, a proposed administrative system, proposed statutory language, etc. Appendices contain: proposed rules, questionnaires, notices & forms, & more. Brief section on national efforts to combat fraud.
Workersa Compensation Law provides an in-depth look at the day-to-day practice of this field while addressing theoretical aspects that form a critical foundation for this branch of law. Reviews how a worker's compensation case begins and explains activities involved in those cases, such as drafting petitions, presenting cases to an administrative law judge, and bringing an appeal. The theoretical basis of the material is laid out in easy to understand and enjoyable format reinforced with practical real-life examples. Although written with paralegal-specific information, the content includes information vital to anyone dealing with Workersa Compensation issues.
Workers' compensation causes headaches throughout all levels of an organization. Injuries affect production, costs, and morale. Managing Workers' Compensation: A Guide to Injury Reduction and Effective Claim Management lays out - in logical order - management and safety procedures that reduce injuries and the aggravation that follows. The authors cover hiring, training, and managing employees with injury avoidance in mind. They provide a blueprint for dealing with injured employees and their families, and for determining the correct time for the employee to return to work. The book discusses the all-important issues of fraud, modified duty, substance abuse testing and accident investigations. It also provides guidance for managing your organization's safety efforts in a manner that targets workers' compensation cost control as one of its major objectives. In addition to comprehensive coverage of workers' compensation, the book gives you a thorough explanation of additional sources of assistance, including the availability and utility of Internet safety resources, a complete listing of state workers' compensation agencies, and sample checklists that help you evaluate your workplace. Although workers' compensation laws vary from state-to-state, the principles behind the system and the ability of employers to influence their own premiums remain consistent. By gaining a thorough understanding of these principles and implementing proven cost control strategies, you can realize substantial savings. Managing Workers' Compensation: A Guide to Injury Reduction and Effective Claim Management explains the process by which premiums are calculated and shows how you can impact - favorably - the amount your organization pays in premiums.
As the debate over health care reform continues, costs have become a critical measure in the many plans and proposals to come before us. Knowing costs is important because it allows comparisons across such disparate health conditions as AIDS, Alzheimer's disease, heart disease, and cancer. This book presents the results of a major study estimating the large and largely overlooked costs of occupational injury and illness--costs as large as those for cancer and over four times the costs of AIDS. The incidence and mortality of occupational injury and illness were assessed by reviewing data from national surveys and applied an attributable-risk-proportion method. Costs were assessed using the human capital method that decomposes costs into direct categories such as medical costs and insurance administration expenses, as well as indirect categories such as lost earnings and lost fringe benefits. The total is estimated to be $155 billion and is likely to be low as it does not include costs associated with pain and suffering or of home care provided by family members. Invaluable as an aid in the analysis of policy issues, Costs of Occupational Injuryand Illness will serve as a resource and reference for economists, policy analysts, public health researchers, insurance administrators, labor unions and labor lawyers, benefits managers, and environmental scientists, among others. J. Paul Leigh is Professor in the School of Medicine, Department of Epidemiology and Preventive Medicine, University of California, Davis. Stephen Markowitz, M.D., is Professor in the Department of Community Health and Social Medicine, City University of New York Medical School. Marianne Fahs is Director of the Health Policy Research Center, Milano Graduate School of Management and Urban Policy, New School University. Philip Landrigan, M.D., is Wise Professor and Chair of the Department of Community Medicine, Mount Sinai Medical Center, New York.
Workers' compensation was arguably the first widespread social insurance program in the United States--before social security, Medicare, or unemployment insurance--and the most successful form of labor legislation to emerge from the early progressive movement. In A Prelude to the Welfare State, Price V. Fishback and Shawn Everett Kantor challenge widespread historical perceptions by arguing that workers' compensation, rather than being an early progressive victory, succeeded because all relevant parties--labor and management, insurance companies, lawyers, and legislators--benefited from the ruling.
Who steals? An extraordinary range of folk -- from low-life hoods who sign on as Medicare or Medicaid providers equipped with nothing more than beepers and mailboxes, to drug trafficking organizations, organized crime syndicates, and even major hospital chains. In License to Steal, Malcolm K. Sparrow shows how the industry's defenses, which focus mostly on finding and correcting billing errors, are no match for such well orchestrated attacks. The maxim for thieves simply becomes "bill your lies correctly." Provided they do that, fraud perpetrators with any degree of sophistication can steal millions of dollars with impunity, testing payment systems carefully, and then spreading fraudulent billings widely enough across patient and provider accounts to escape detection. The kinds of highly automated, quality controlled claims processing systems that pervade the industry present fraud perpetrators with their favorite kind of target: rich, fast paying, transparent, utterly predictable check printing systems, with little threat of human intervention, and with the U.S. Treasury on the end of the electronic line. Sparrow picks apart the industry's response to the government's efforts to control this problem. The provider associations (well heeled and politically influential) have vociferously opposed almost every recent enforcement initiative, creating the unfortunate public impression that the entire health care industry is against effective fraud control. A significant segment of the industry, it seems, regards fraud and abuse not as a problem, but as a lucrative enterprise worth defending. Meanwhile, it remains a perfectly commonplace experience for patients or their relatives to examine a medical bill and discover that half of it never happened, or that; likewise, if patients then complain, they discover that no one seems to care, or that no one has the resources to do anything about it. Sparrow's research suggests that the growth of capitated managed care systems does not solve the problem, as many in the industry had assumed, but merely changes its form. The managed care environment produces scams involving underutilization, and the withholding of medical care schemes that are harder to uncover and investigate, and much more dangerous to human health. Having worked extensively with federal and state officials since the appearance of his first book on this subject, Sparrow is in a unique position to evaluate recent law enforcement initiatives. He admits the "war on fraud" is at least now engaged, but it is far from won.
This new edition of the Handbook of Insurance reviews the last forty years of research developments in insurance and its related fields. A single reference source for professors, researchers, graduate students, regulators, consultants and practitioners, the book starts with the history and foundations of risk and insurance theory, followed by a review of prevention and precaution, asymmetric information, risk management, insurance pricing, new financial innovations, reinsurance, corporate governance, capital allocation, securitization, systemic risk, insurance regulation, the industrial organization of insurance markets and other insurance market applications. It ends with health insurance, longevity risk, long-term care insurance, life insurance financial products and social insurance. This second version of the Handbook contains 15 new chapters. Each of the 37 chapters has been written by leading authorities in risk and insurance research, all contributions have been peer reviewed, and each chapter can be read independently of the others.
Featuring insightful, actionable and proven cost-saving ideas, How To Save Big On Workers' Compensation shows how employers can maximize productivity and profits through safety and a culture of caring. This essential guide shares strategies that saved a quarter of a billion dollars. This easy-to-read book includes exclusive interviews with leading industry experts. The experts include Larry LaPointe, former director of the Division of Confidential Investigations at the New York State Insurance Fund (NYSIF); Ed Hiller, director of Claims and Medical Operations for NYSIF; Brian Mittman, the managing partner of Markhoff & Mittman, a law firm helping injured workers; Robert Firmbach, a veteran loss-control and safety expert; Eileen Preiato, the Friedlander Claims Solution manager; and Cosmo Preiato, executive vice president of Friedlander Group and leader of Safety Group Underwriting and Operations. "Friedlander's approach in this well-written, helpful book is to focus on what employers can do to minimize workers' compensation claims in the first place. He believes that by creating a "culture of caring," employers can effectively save money on workers' compensation, because "that culture will maximize your productivity, efficiencies, and profits." ...This revelation alone makes the book valuable, along with several eye-opening interviews with workers' compensation experts. Employers will gain insight into such key issues as claims and premium fraud, abuse of the system, loss control and reducing the cost of claims. A thoughtful book that could actually save employers some serious money." Kirkus Review "During my time as CEO of the New York State Insurance Fund, Adam always displayed a keen insight into the intricate workings of the state compensation system. He is a true comp professional who understands the needs of the system's stakeholders; policyholders, associations, injured workers and policy makers. His primer is a must read for those involved in our industry. Ken Ross, CEO/President, Pinnacol Assurance "How to Save Big on Workers' Compensation is interesting, informative and a must read book. Adam uses his vast knowledge, candid insights including interviews with true experts in workers' compensation to discuss issues related to fraud, claims, safety and loss control. The book focuses on safety prevention as a major linchpin of effective cost control resulting in lowering premium costs. The reader should benefit from this unique review of important issues." Donald T. DeCarlo, J.D. CEO AMCOMP, Commissioner of NYS Insurance Fund, 1997-2009 "Adam offers a number of key concepts - such as managment-employee relations and a culture of caring - that are very straight forward and really work to control workers' compensation costs. His interviews with industry experts deliver the information in an easy-to-understand, real-world style. This is a great book for virtually every American business." Dennis Otmaskin, CPCU Regional President, Northeast & Mid-Atlantic Harleysville Group "I found it to be a riveting book, presented in a manner that every employer would clearly enjoy reading and would cut the cost to his bottom line. This should be considered a training manual. This is also a worthwhile book for every Insurance Broker to read and present to every business client. It presents a powerful bit of knowledge." Arthur Natter, former broker and NYSIF retiree "Adam's a serious professional and a clear-headed writer." Steve Acunto, Editor & Publisher of Insurance Advocate "I had an opportunity to read "How to $ave Big on Workers' Compensation." It is exceptional! I especially like the way you started the book with Establishing A Culture of Caring!" Scott Addis, The Addis Group "Adam, I just finished your book. Quite simply, it was fantastic. I will be purchasing and sending a few copies to my peers. Thank you for your contributions." Brian Nebel, P2P Insurance Agency, Partner