King of Prussia, Pa. (March 29, 2016) — MedRisk’s Chief Strategy Officer Ruth Estrich and Macy’s Vice President of Risk Management Ann Schnure will share the stage at the 2016 RIMS Annual Conference and Exhibition on April 12. 

Their presentation, “Overcoming Psychosocial Barriers to Recovery:  Is it a Viable Solution?” explores integrated, patient-centric solutions to both physical and psychosocial barriers to recovery in workers’ compensation cases. Estrich and Schnure highlight psychosocial risk factors that affect work disability and share successes from a comprehensive, integrated program.  They also present strategies for evaluating and implementing delayed-recovery programs and key metrics for measuring return on investment. 

The session starts at 10:15 a.m. on Tuesday April 12.  RIMS will be held in San Diego, April 10-13.  For more information, please see https://www.rims.org/RIMS16/Pages/Home.aspx.

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. To learn more, follow MedRisk on Facebook and LinkedIn, https://www.facebook.com/MedRisk and  https://www.linkedin.com/company/medrisk-inc-/.

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

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

Atlanta (March 22, 2016) – PRIUM executives take the stage several times during the National Rx Drug Abuse and Heroin Summit, March 28-31 in Atlanta.  PRIUM is a medical intervention company specializing in pain management for injured workers.

PRIUM’s President Michael Gavin, American Airline’s Director of Workers’ Compensation Jennifer Saddy, and the Treatment Research Institute’s Dr. David Gastfriend present “Advances in Treating Chronic Pain and Addiction” on March 29 at 3:30 p.m. The session focuses on psychosocial influences on chronic pain, non-pharmaceutical treatments, and managing workers’ compensation claims involving psychosocial pain.

“We need to address the intersection of chronic pain, mental health and addiction,” Gavin said. ”This is a complicated and expensive group of patients with unique needs.”

On March 30 at 11:15 a.m., PRIUM’s Senior Vice President Mark Pew and CompPharma’s Joe Paduda discuss how workers’ compensation drug formularies reduce opioid prescriptions and the clinical, logistical and regulatory components of a successful formulary.

“State formularies can positively influence prescribing behavior to help injured employees receive the most appropriate medications in a timely manner,” Pew said.

Pew returns for “The Five Things You Need to Know About: Marijuana & the Workplace; Litigation; Big Marijuana.” He discusses the implications of marijuana to the workplace, the impacts to employees and employers, and provides takeaways for advocacy. This session occurs on March 31 at 1:45 p.m. during The 3nd Annual SAM (Smart Approaches to Marijuana) Education Summit held in conjunction with the National Rx Drug Abuse and Heroin Summit.

The venue for both events is The Westin Peachtree Plaza, Atlanta.  For more information, please see http://nationalrxdrugabusesummit.org/.

About PRIUM

An Ameritox solutions provider, PRIUM sets the industry standard for workers' compensation medical interventions through a collaborative physician engagement process encompassing evidence-based medicine, clinical oversight, and jurisdictional guidelines to ensure optimal financial and clinical outcomes. PRIUM’s ability to secure higher agreement rates with physicians to modify treatment plans and ensure compliance is unmatched. The hallmark of the medical intervention company's success is to eliminate unnecessary treatment through a comprehensive approach that includes complex medical interventions, utilization reviews, and independent medical exams.  Based in Duluth, Ga., PRIUM can be reached at www.prium.com or 888-588-4964.

Website: www.prium.com

Blog: www.priumevidencebased.com

linkedin.com/in/markpew

Twitter: @PRIUM1 and @RxProfessor

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Contact:  Helen Patterson, 813-690-4787, helen@kingknight.com

Delray Beach, Florida (January 25, 2016) — Tower MSA Partners has rolled out its comprehensive MSP Automation Suite. The sophisticated technology drives all the processes Tower has perfected to proactively manage Section 111 Mandatory Insurer Reporting, the recently implemented Conditional Payment Notice process, and to stage workers’ compensation claims for Medicare Set-Asides and closure. 

“Essentially, it automates our best practices for Medicare Secondary Payer compliance, claims optimization and MSA preparation,” said Tower CEO Rita Wilson.

Tower distinguishes itself by reducing medical and pharmaceutical costs before preparing MSAs.  “Our Pre-MSA Triage identifies barriers to settlement and recommends claim-specific interventions, like physician peer review and clinical oversight, to remove those barriers long before preparing an MSA,” she added.

The MSP Automation Suite can track a claim from Medicare beneficiary identification through final settlement. It records every claim activity performed by Tower or its network of practicing physicians and pharmacists and provides clients with 24/7, end-to-end visibility into claims. The system prompts for missing data, conditional payment searches, and medical/pharmaceutical interventions and sends electronic updates to clients at appropriate data points.

“Clients don’t need to manually diary activities or call to check on things,” Wilson said. “The system shows exactly when a phone call was made and follow-up is due.”

The MSP Automation Suite seamlessly integrates data from all types of claims systems and client business rules can be imbedded into the software alongside Tower’s rules for true business process management. “Automation frees claims professionals to address issues that require a human touch,” Wilson said.

About Tower MSA Partners

Headquartered in Delray Beach, Fla., Tower MSA Partners’ services include pre-MSA Triage, MSAs, physician peer reviews, conditional payments, Section 111 reporting, CMS submissions, MSA administration, medical cost projections, and life care plans. 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 and remains involved in claims through final resolution. 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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Media Contact:  Helen Patterson, King Knight Communications, 813-690-4787; helen@kingknight.com

Pew and Walmart share its opioid management success story; then he discusses trends in urine drug screening with CWCI’s Alex Swedlow

Las Vegas, Nevada (November 3, 2015) – PRIUM’s Senior Vice President Mark Pew will participate in two sessions at the National Workers’ Compensation and Disability Conference & Expo.  The conference will be held at Mandalay Bay in Las Vegas, November 11 through 13. 

Pew and Walmart’s Director of Workers’ Compensation Janice Van Allen will share how the retailer used lessons it learned from reducing opioid misuse in legacy claims to develop a data-driven methodology for preventing drug misuse on new claims.  The interactive session, which starts at 2:30 p.m. on Wednesday, November 11, will provide prescription drug mitigation strategies, metrics for measuring success, and foundational principles to consider when creating an early intervention program.

“PRIUM helped Walmart create a program to address dangerous drug regimens that changed people’s lives,” Pew said.  “Beyond reducing the use of dangerous drugs and creating preventative measures for future treatment, they established a workplace culture of transparency that is to be envied.”

On November 12, at 2 p.m., Pew and California Workers’ Compensation Institute President Alex Swedlow will discuss trends in urine drug screening. Swedlow will review the latest CWCI research on the practice of urine drug screening. Pew will share best practices for urine drug management, its place in a full strategy for ensuring proper medication use, and how testing can help provide better care.

To read more about these presentations, please go to http://tinyurl.com/PRIUMNational. 

PRIUM will also exhibit at Booth 239 at the conference. 

About PRIUM

An Ameritox solutions provider, PRIUM sets the industry standard for workers' compensation medical interventions through its ability to secure higher agreement rates and ensure compliance with modified treatment plans. The hallmark of the medical intervention company's success is a collaborative physician engagement process encompassing evidence-based medicine, clinical oversight, and jurisdictional guidelines to ensure optimal financial and clinical outcomes. PRIUM eliminates unnecessary treatment through a comprehensive approach that includes complex medical interventions, utilization reviews, and independent medical exams.  Based in Duluth, Ga., PRIUM can be reached at www.prium.net or 888-588-4964.

Website: www.prium.net

Blog: www.priumevidencebased.com

linkedin.com/in/markpew

Twitter: @PRIUM1 and @RxProfessor

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Contact:  Helen Patterson, 813-690-4787, helen@kingknight.com

Chamila Adhihetty and Suzette Carlisle Received Grants to Further their Workers’ Compensation Careers

Madison, Wis. (Oct. 2, 2014) — The International Association of Industrial Accident Boards and Commissions (IAIABC) awarded educational grants to Chamila Adhihetty of Toronto, Ontario and Suzette Carlisle of St. Louis, Missouri.  Each received a $3,000 grant toward studies to advance her workers’ compensation career.

“As part of our centennial celebration, the organization wanted to support the development of workers’ compensation leaders,” said IAIABC’s Executive Director Jennifer Wolf Horejsh.  Grant applicants needed to pursue a career in workers’ compensation or a related field, such as risk management, occupational health or public administration.  A committee comprised of IAIABC members selected two recipients who turned out to be graduate students.

A senior scientist in the Occupational Disease Policy and Research Branch for the Ontario Workplace Safety and Insurance Board (WSIB), Adhihetty will use her grant to continue work on a PhD in Health Services Research at the University of Toronto.  She is writing a dissertation on same-level falls and prevention initiatives in the workplace.  She interned with WSIB while working on her master’s degree and has worked for the board for 10 years.

Carlisle has worked in Missouri’s workers’ compensation system for 16 years, first as a legal advisor and then as an administrative law judge.  She recently received her master’s degree in Judicial Studies from the University of Nevada-Reno, where she will earn her PhD. Continue reading →

Studies show claims with physician dispensed drugs have longer claims duration, poorer outcomes, and higher costs.

Raleigh, N.C. (Sept. 30, 2014) – Worker’s compensation pharmacy expert Joe Paduda, principal of Health Strategy Associates, LLC and president of CompPharma, LLC shares the latest study results on physician dispensing of repackaged prescription drugs at the 19th Annual North Carolina Workers’ Compensation Educational Conference.  Scheduled from October 8 through 10, the conference takes place at the Raleigh Convention Center, 500 South Salisbury Street in Raleigh, NC.

Paduda discusses studies showing that physician-dispensed opioids lead to longer treatment durations and indemnity periods, poorer outcomes, and dramatically higher claims costs.

“The Workers’ Compensation Research Institute’s recent report on physician dispensing of drugs in Pennsylvania provides a clear warning to North Carolina’s employers and taxpayers,” Paduda says.  “Without effective controls on the practice of dispensing, Pennsylvania saw physician-dispensed medications increase from 17 percent of total drug costs to almost half within four years, due mostly to a huge markup in prices. Doctors were paid $7.89 per pill for generic Prilosec, compared to $0.67 per pill at Walgreens.”

Paduda also highlights patient safety risks that occur when physician-dispensed prescriptions bypass the safeguards provided by pharmacies and pharmacy benefit managers (PBMs).  Pharmacies can’t check prescriptions for interactions or provide counseling, and workers’ compensation PBMs cannot identify conflicts or monitor the total morphine equivalents patients receive when the transactions circumvent their systems.

Additionally, a Johns Hopkins-Accident Fund study suggests that physician dispensing may incent physicians to prescribe more opioids than necessary. “The number of physician-dispensed prescriptions for opioids was nearly triple that of claims with opioids filled through pharmacies,” Paduda said.  Continue reading →