Five Things You Need to Know: 2/21, Tuesday Edition


1) Sedgwick to Add 150 Jobs and $34 Million in TN Headquarters Expansion (NEWS)

Sedgwick Claims Management Services Inc. based out of Memphis, TN, will add 150 jobs and a $34 million headquarters expansion, writes Wayne Risher of The Commercial Appeal (part of the USA Today Network). "Sedgwick Claims Management Services Inc. proposes to vacate its headquarters at 1100 Ridgeway Loop, where it has been an anchor tenant since 2001, and a second location on Thousand Oaks Boulevard off American Way," according to the article. "Sedgwick was said to be in final negotiations for an undisclosed campus site that can handle more than 1,000 employees." Sedgwick has almost 15,000 global employees, with 275 offices and approximately 2.6 million claimants per year. 


2) Gray's Bill to Save Millions of Dollars in Workers' Comp Fraud (NEWS)

Gray's Bill, signed into law in 2016, will help prevent more than $59 million in fraudulent workers' compensation claims. The bill was sponsored by Assemblyman Adam Gray (D-Merced), according to a statement from his office referenced in a Merced Sun-Star article. "The new law requires the state to suspend any medical provider convicted of fraud from participating in the workers’ compensation system. The state Division of Workers’ Compensation said last week that it used Gray’s bill to suspend seven medical providers who filed more than 8,500 claims totaling $59 million," according to the article.  


3) 3 Strategies to Eliminate Chronic Pain Claims (BLOGWIRE)

Chronic pain is the most prevalent health condition in the U.S. workforce with cost estimates of more than $100 billion annually in lost productivity, healthcare, and workers’ comp/disability payments. The good news is medical science and research has evolved to enable the workers’ comp community to effectively address this prevalent and costly issue. The bad news is many employers and payers believe the steps needed to move injured workers from chronic pain status to productive individual are too complicated and too expensive. They are wrong. To read more, click here.


4) Part D MSP Reform Legislation Re-Introduced in Congress (BLOGWIRE)

On Thursday, February 16, Congressman Tim Murphy (R-PA) and Congressman Ron Kind (D-WI) re-introduced the Secondary Payer Advancement, Rationalization, and Clarification Act (SPARC Act – H.R. 1122) into the US. House of Representatives. For Congressman Tim Murphy’s press release on the SPARC Act’s re-introduction, click here. To read more, click here. 


5) Federal Court Holds Against Medicare Practice of Over-Inclusive Reimbursement Demands (BLOGWIRE)

The California Insurance Guarantee Association (CIGA) has prevailed in its lawsuit (Cali. Ins. Guar. Ass’n v. Burwell, No. 2:15-cv-01113-ODW (FFMx), 2017 U.S. Dist. Ct. LEXIS 1681) against the Centers for Medicare and Medicaid Service (CMS) challenging the practice of over-inclusive reimbursement demands by CMS.  As a consequence of this ruling from the U.S. District Court for the Central District of California, claimants and employers, have judicial support to dispute charges which contain mixed diagnosis codes, some related to the workers’ compensation injury and some unrelated, in CMS’s conditional payment demands. To read more, click here. 


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