June 13, 2019 DWC Newsline Update

From the article: "The Division of Workers’ Compensation (DWC) has posted an order adjusting the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1."

"The Physician and Non-Physician Practitioner Fee Schedule update order adopts the following Medicare changes:

• CMS Medicare National Physician Fee Schedule Relative Value File RVU19C July 1, 2019 quarterly update
  
• National Correct Coding Initiative Practitioner Procedure to Procedure (PTP) Edits July 1, 2019 quarterly update
  
• National Correct Coding Initiative Medically Unlikely Edits July 1, 2019 quarterly update (excluding MUE “0” value codes)
  
• CMS ZIP Code to Carrier Locality files July 1, 2019 quarterly update, for Geographic Practice Cost Index (GPCI) locality mapping"
  

"The order adopting the OMFS adjustments is effective for services rendered on or after July 1, 2019 and can be found on the DWC website."

"Treating the patient - not just the injury - works!"
by Steve Cattolica - June 4, 2019

Ms. Michelle Despres, P.T. recently discussed one of the most widely known secrets of healthcare since the biopsychosocial model of practicing medicine was first discovered by a mother, father, grandparent or other loving adult when their child fell and skinned their knee. Studies by universities have confirmed what they knew!  Treating the patient - not just the injury - works!

With zeal to put this age old “secret” into practice, workers’ compensation systems nationwide have developed complete infrastructures capturing and packaging and controlling their contracted providers on behalf of their client, the claims administrator.  That infrastructure, including the costs of the claims duties it is purported to replace as more efficient, is now the costliest component in the work comp system - not injured worker indemnity benefits and not the actual hands-on care.

Let’s quickly examine the components of the model: