National speakers include Rear Admiral Pamela Schweitzer, CMS’s John Albert and U.S. Senator Bill Cassidy, MD

BALTIMORE, MD (September 7, 2017) — The National Alliance of Medicare Set-Aside Professionals (NAMSAP) has announced the speakers and agenda for its 2017 Annual Conference, taking place September 27 through September 29 at the Renaissance Baltimore Harborplace Hotel.

The conference features an impressive line-up of nationally recognized speakers, including Rear Admiral Pamela Schweitzer, PharmD, Assistant Surgeon General and Chief Pharmacy Officer, U.S. Public Health Service. U.S. Senator Bill Cassidy, MD of Louisiana and Bradley Martin, PharmD, PhD, with the University of Arkansas and a regular contributor to Centers for Disease Control (CDC) research publications, will join her on the “War on Opioids – Where Are We Now?” panel. Additionally, John P. Albert, senior technical advisor for the Centers for Medicare and Medicaid Services (CMS) Division of Medicare Secondary Payer Operations, discusses Section 111 Reporting and MSP Compliance.  

“We have excellent content and prominent speakers to cover the ever-changing landscape of MSP compliance and MSAs, making this the preeminent educational event for our industry,” said NAMSAP President Shawn Deane, JD, MEd, MSCC, CMSP, with ISO Claims Partners. Topics range from the latest on conditional payments, re-reviews, and non-submit programs to pending legislation and the impacts of the Trump administration and the new Workers' Compensation Review Contractor. Topic descriptions can be found at www.namsap.org/?page=2017AnnualAgenda.

A pre-conference session, slated for 9 a.m. to noon on September 27, updates attendees on legislation, regulations and significant case laws, the new Workers’ Compensation Medicare Set-Aside Reference Guide, and use of the RED BOOK pricing methodology. 

For registration and other information, please see www.namsap.org/events/EventDetails.aspx?id=946953 or contact Angie Coleman at angie@NAMSAP.org or 630-617-5047.

About NAMSAP

The National Alliance of Medicare Set-Aside Professionals (NAMSAP) is the only non-profit association exclusively addressing the issues and challenges of the Medicare Secondary Payer Statute and its impact on workers’ compensation and liability settlements. Through the voluntary efforts of our members, NAMSAP is a forum for the exchange of ideas and is a leading resource for information and news in this constantly evolving area of practice. The collective knowledge of our members and NAMSAP’s resources will provide attorneys, nurses, settlement planners, claims professionals, and others with the ingredients essential to their success.

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Media Contact:  Angie Coleman, NAMSAP, 630-617-5047, angie@NAMSAP.org

King of Prussia, Pa. (September 12, 2017) — Mike Ryan has been promoted to Chief Executive Officer and President of MedRisk, the leading managed care company specializing in physical rehabilitation within workers’ compensation. Founder Shelley Boyce is maintaining an active role as Executive Chairman.

“Mike’s strategic thinking and outstanding leadership have been pivotal to our record-breaking growth,” said Boyce, noting that MedRisk has experienced a 21 percent organic compound annual growth rate during Ryan’s six-year tenure.

As CEO and President, Ryan is responsible for MedRisk’s performance, overseeing strategic business initiatives and providing organization-wide leadership. Boyce is focusing on the ongoing evolution of the company’s product offerings and broader business partnerships.

Ryan has over 19 years’ experience in the insurance industry, having worked with major workers’ compensation carriers and third party administrators. He joined MedRisk in 2011 to develop and implement company-wide growth initiatives and became President in 2013.

"Advances in telehealth and value based care provide MedRisk with incredible opportunities,” Ryan said.  "We need to build for the future and Shelley has the entrepreneurial spirit and vision to drive those innovations.”

Founded in 1994 and listed as one of the Inc. 5,000 fastest growing privately held companies for 11 consecutive years, MedRisk counts over 115,000 providers in its network and serves almost 500,000 injured workers every year. MedRisk is the largest managed care organization dedicated to the physical rehabilitation of injured workers and holds direct contracts with more than 80 percent of the nation’s top workers’ compensation insurers and TPAs.

About MedRisk

Based in King of Prussia, Pa., MedRisk is the leader in physical rehabilitation solutions for the workers’ compensation industry. The company’s programs deliver savings and operational efficiencies that are significantly greater than traditional programs. MedRisk, which has successfully completed a SSAE 16 Type II examination, ensures high quality care and delivers outstanding customer service. To that end, all customer service professionals, healthcare advocates and physical therapists are based in the U.S. Customers include insurance carriers, self-insured employers, third-party administrators, state funds, and case management companies. For more information, visit www.medrisknet.com or call 
800-225-9675.

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Media Contacts: 
Helen King Patterson, APR, King Knight Communications, 813-690-4787; helen@kingknight.com
Rommy Blum, MedRisk, 800-225-9675 ext. 1150; rblum@medrisknet.com

HomeCare Connect Incorporates Telehealth into its Workers’ Compensation Home Healthcare Services

Live video interactions among injured employees, their home health caregivers and their clinicians are expected to speed the delivery of care, improve communication and increase patient satisfaction.

WINTER PARK, FLA. (February 28, 2017) – HomeCare Connect, which manages the quality and cost of workers’ compensation home healthcare, is integrating telehealth capabilities into its services.

Accessible via mobile telephones, computers and tablets, HomeCare Connect’s Tele-Connect is a cloud-based application that enables injured employees and their home health caregivers to meet virtually with HomeCare Connect’s clinical care coordinators to discuss treatment.

“Live video interactions are more personal than telephone conversations and help clinicians see what’s going on,” said Chief Marketing Officer Vonesa Wenzel. “If a wound is not healing properly, a treating physician can watch wound care being administered and recommend changes in real time. This accelerates the delivery of appropriate care, speeds recovery and may eliminate the need for a doctor’s office visit.”

Providing telehealth services at no additional charge to customers, HomeCare Connect will use the application to clarify treatment, educate injured employees, monitor the use of durable medical equipment, and help amputees adjust to prosthetics. Tele-Connect will also be used to take adjusters on virtual walk-throughs before, during and after home modifications.

“We’re the first home healthcare network in workers’ compensation to adopt telehealth technology,” Wenzel said, noting that some companies use it for case management and triage.  “I’m sure we’ll discover other benefits as we integrate the technology.”

About HomeCare Connect

Specializing in catastrophic cases, HomeCare Connect focuses exclusively on managing the quality and cost of home health, durable medical equipment and supplies for workers’ compensation payers. With more than 17,000 contracted network providers, its services include nursing, home infusion, respiratory therapy, speech and occupational therapy, prosthetics and orthotics, and the coordination of DME and supplies along with home modifications. HomeCare Connect’s partners consolidated their 20-plus years of workers’ compensation experience into offerings and service standards that ensure that injured workers receive excellent care in the fastest time frames at the most affordable prices. HomeCare Connect guarantees response to referrals within two hours and the delivery of an initial medical summary within two days. Based near Orlando, the privately held company serves clients nationally and can be reached at www.homecareconnect.com or 855-223-2228. 

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Media Contact:  Helen Patterson, King Knight Communications, 813-690-4787 helen@kingknight.com

New work comp medical cost containment program delivers savings, clinical intervention and transparency.

New Orleans, La. (November 30, 2016) – MedRisk announced a new workers’ compensation cost containment service model, NexGen Advantage, at the National Workers’ Compensation & Disability Conference & Expo.

“Traditional medical cost containment program results are plateauing, yet payers are still losing between three to five million dollars in savings for every $100 million spent on medical services,” said Mary O’Donoghue, MedRisk’s Chief Product Development Officer. She noted that approximately seven percent of medical payments are improperly paid. 

NexGen Advantage is the industry’s first single solution that uses analytics and technology to identify and deliver the best combination of strategies to ensure accurate and fair medical payment of individual bills. “NexGen leverages the buying power of a mega network with more than 900,000 providers, an incredibly powerful data analytics system, and expert clinical intervention to capture additional savings after bill review, make payers’ lives easier, and improve provider partnerships,” O’Donoghue added.

NexGen Advantage runs a payer’s bill data through a sophisticated analytic that examines a number of factors, including jurisdiction, bill type, facility, and provider type. There is a single, flat access fee. Taking each payer’s business objectives into account, the program determines where a preferred provider organization is most effective and where other cost containment strategies are best for all parties.

Online access to data and peer-to-peer conversations with providers about benchmarking, coding and payments help to reduce provider confusion.

“NexGen Advantage supports a partnership between payers and providers by delivering full transparency for fair and appropriate payment, “O’Donoghue said. “This is particularly important as the industry looks toward building stronger, outcomes-oriented networks.”

About MedRisk
MedRisk is the leader in physical rehabilitation and diagnostic imaging solutions for the workers’ compensation industry. Founded in 1994 and based in King of Prussia, Pa., MedRisk is accredited under URAC for utilization management and has successfully completed a SSAE 16 Type II examination. MedRisk’s programs deliver savings and operational efficiencies that are significantly greater than traditional programs. Customers include insurance carriers, self-insured employers, third-party administrators, state funds, and case management companies.

To make a referral or obtain more information, visit www.medrisknet.com or call 800-225-9675.

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Media Contacts: 
Helen Patterson, King Knight Communications, helen@kingknight.com, 813-690-4787

Rommy Blum, MedRisk, Inc., 800-225-9675 ext. 1150; rblum@medrisknet.com

Delray Beach, Fla. (November 30, 2016) — Tower MSA Partners, which provides Medicare Secondary Compliance services and Medicare Set-Asides in workers’ compensation and liability, has selected Dan Anders as Chief Compliance Officer.  This is a new, senior management position that oversees all aspects of regulatory compliance associated with the Medicare Secondary Payer Statute and local, state and federal laws.

“Dan’s vast experience in MSP compliance and his ability to navigate the complex legal issues associated with MSAs and conditional payments make him a perfect candidate to lead Tower’s legal and compliance team.   We are delighted to have someone of his expertise to drive future growth,” said CEO Rita Wilson.

An attorney and a certified Medicare Set-Aside Consultant, Anders brings more than 13 years’ experience in MSP compliance and MSAs to this role. Most recently, he was the senior vice president of MSP Compliance for ExamWorks Clinical Solutions, and previously he served for five years as compliance director for MedAllocators, which was acquired by ExamWorks in 2014.

Anders started his career as an attorney with Wiedner & McAuliffe in Chicago, Illinois, where his responsibilities included developing policies for handling Medicare requirements in workers’ compensation cases and preparing and submitting MSAs to CMS. He has presented at industry conferences and written a number of articles and blog posts on compliance issues.

Anders earned his Juris Doctor degree from Chicago-Kent College of Law in Chicago and his bachelor’s degree from Loyola University also in Chicago.  He is a member of the National Alliance of Medicare Set-Aside Professionals and the Illinois State Bar Association. 

About Tower MSA Partners

Headquartered in Delray Beach, Fla., Tower MSA Partners’ services include pre-MSA Triage, MSAs, physician peer reviews, CMS submissions, MSA administration, medical cost projections, life care plans, conditional payments, and Section 111 reporting. With more than 50 years combined experience in pharmacy, legal oversight and medical care, Tower proactively stages claims, working collaboratively with clients to identify issues and intervene to modify outcomes.  Tower remains involved in the claims, through final resolution, MSA and/or other settlement. This model enables Tower’s clients to provide better care to injured workers, reduce claim and MSA costs, and obtain CMS acceptance of the MSA. For more information, visit www.towermsa.com and www.mspcomplianceblog.com. 

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Business Wire version w/photo: Dan Anders Joins Tower MSA Partners as Chief Compliance Officer

Request photo from helen@kingknight.com

Media Contact:  Helen Patterson, King Knight Communications, 813-690-4787; helen@kingknight.com

Survey shows 8.7 percent reduction in worker’s compensation payers’ drug spend

Maggie Valley, North Carolina (November 1, 2016) – CompPharma’s 13^th Annual Survey of Prescription Drug Management in Workers’ Compensation showed an 8.7 percent reduction in payers’ pharmacy spend. The survey analyzed the 2015 pharmacy cost data of 30 workers’ compensation insurance carriers, third-party administrators, self-insured employers, and state funds. 

Payers credited tighter clinical management, better integration with their pharmacy benefit managers, and prescriber interventions for the decrease.  All have opioid management programs to limit the number of initial opioid prescriptions and/or decrease morphine equivalents across as many claims as medically appropriate.  

“Twenty percent of the respondents also had assertive settlement initiatives and have been closing older claims,” said Joseph Paduda, president of CompPharma, LLC.  “Overall, payers have seen drug costs go down by 11 percent in the past six years despite the 2014 increase.”

Opioids remained the number-one payer concern with compounds ranking as the main emerging issue. 

PBM consolidations received mixed reactions from the payer community.  Some respondents hoped mergers would bring better pricing and more clinical capabilities while others expressed concern that the lack of competition would breed complacency. 

“There is a sense of acceptance along with a little wariness about potential customer service issues,” Paduda said.  “Consolidation in other segments of the industry has spawned customer service problems when people-based operating models were replaced with offshored or tech-enabled models.”

A complimentary copy of the 2016 survey can be downloaded from www.comppharma.com.

About CompPharma

Established by industry consultants Joseph Paduda and Helen King Patterson, CompPharma, LLC is a consortium of workers’ compensation PBMs active in workers compensation.  More information is available at www.comppharma.com or by contacting Patterson at 813-690-4787 or hpatterson@comppharma.com.

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Media Contact:  Helen Patterson, 813-690-4787; hpatterson@comppharma.com

Workers’ compensation nurse case management company now provides services in Mississippi

Owings Mills, Md. (October 11, 2016) — Restore Rehabilitation, a medical and vocational case management company focused on reducing the cost of workers’ compensation claims through high quality medical treatment, recently introduced field case management services into the state of Mississippi.

Restore’s field case managers maintain advanced credentials and have at least three years of experience in workers’ compensation. Most often used on complex cases involving multiple body parts, amputations, severe burns, spinal cord damage, and comorbidities, field case managers are also helpful with unwitnessed or questionable injuries.

“Mississippi represents an ideal territory for expansion based on our market penetration in the bordering states,” said Restore Rehabilitation President and CEO Pam Anthony.  “There are approximately three million people residing in Mississippi, and Restore is confident in our ability to have a positive impact on the state’s workers’ compensation needs.”

Field case managers evaluate injured employees’ treatment plans to assist them in navigating the complicated workers’ compensation maze. They help identify high quality medical providers and potential return to work hurdles, while helping injured employees achieve maximum medical improvement and full return-to-work status.

“In response to the market’s need for a national boutique case management firm, Restore welcomes the opportunity to expand our geographic footprint,” Anthony added. “Restore continues to hire high caliber talent and is currently seeking experienced case managers in Colorado, Massachusetts, Maryland, Tennessee, Texas, Virginia, and Washington, D.C.”

About Restore Rehabilitation

Celebrating its 10^th anniversary, Restore Rehabilitation offers an early intervention program, bilingual services, catastrophic case management, life care planning, file reviews, and medical cost allocations. In addition to providing telephonic case management in all 50 states, Restore now delivers field case management services in: Alabama, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Maryland, Massachusetts, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, and Washington, D.C. Based in Owings Mills, Maryland, Restore Rehabilitation can be reached at 866-581-8771 or www.restorerehab.biz. 

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Link to release on Business Wire Restore Rehabilitation Announces More Growth

Contact:  Helen Patterson, King Knight Communications, 813-690-4787; helen@kingknight.com

Error rates in diagnostic imaging can be as high as 30 percent. Often a busy primary care physician will order a CT when an MRI is needed or request an exam of the wrong body part or site. Sometimes imaging centers run tests on the wrong patient, a mistake that occurs just by calling a patient out of the waiting room by the first name only.

MedRisk – known for making sure that injured workers receive the right treatment from the right provider at the right time – identifies typical errors and recommends ways to avoid them in this whitepaper.

Owings Mills, Md. (March 29, 2016) — Restore Rehabilitation has launched a national telephonic case management service for workers’ compensation payers. Based in Maryland, Restore is a medical and vocational case management company focused on reducing the impact of workers’ compensation claims on injured workers, insurers, third-party administrators, and employers.

Restore’s telephonic case managers contact injured employees immediately after an injury to assess medical status and medical needs, determine next steps, assist in identifying physicians, and schedule appointments. “On the first call, we tell the injured employee that the employer wants us to help them navigate the work comp system,” said Restore Rehabilitation’s President Pam Anthony, RN, BSN, CDMS, CCM.  “Knowing your employer cares goes a long way.”

Restore’s telephonic case managers, who are registered nurses with advanced credentials, facilitate, educate and communicate so injured employees receive needed care as quickly as possible. This involves scheduling and following up on appointments, obtaining test results and medical records, and coordinating ancillary services. Case managers help injured employees understand their medical conditions, tests and treatment plans. Services include obtaining job descriptions, guiding return-to-work plans, monitoring psychosocial issues, and continually updating adjusters, employers and other stakeholders.

Restore Rehabilitation emphasizes superior customer service.  There is a dedicated multi-lingual team of case managers and a person answers the phone between 8:30 a.m. and 8 p.m. eastern to avoid voice mail delays.

“Our philosophy is to recruit, hire and train only the best of the best,” Anthony said, noting that Restore’s case managers are employees, not independent contractors.  “Our case managers are highly trained, credentialed and extremely experienced in workers’ compensation. Reasonable caseloads allow for proactive results-based services that surpass industry standards and exceed clients’ expectations.” 
 

About Restore Rehabilitation

Serving the workers’ compensation community, Restore Rehabilitation provides national telephonic case management, and field case management in 21 states.  It also offers an early intervention program, bilingual services, catastrophic case management, life care planning, file reviews, and medical cost allocations. Based in Owings Mills, Maryland, Restore Rehabilitation can be reached at 866-581-8771 or www.restorerehab.biz.  Pamela Anthony founded Restore Rehabilitation in 2006 and has grown it from two nurse case managers to 125 case managers.

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Media Contact:  Helen Patterson, APR, King Knight Communications, 813-690-4787; helen@kingknight.com