LETTERS
Work-Comp, Cont’d
I am a business owner who provides medical supplies and services to the workers’ compensation industry. I am so tired of the fraud and abuses in the system that I am lobbying our political representatives, offering my knowledge of the situation. I enjoy Vita Reed’s articles and thought I would share some information.
There has been a lot of talk about reforming the California workers’ compensation market, and to do so is imperative if we are to keep our major employers in the state. The problem is very extensive, and while I realize that medical-supply costs in the workers’ comp market are small in comparison with surgery and fraud, there are two areas where there could be an immediate cost savings.
First, medical suppliers currently do not need prior authorization for dispensing “durable medical equipment.” Without a requirement for prior authorization, doctors’ offices and surgery and rehabilitation clinics can directly dispense medical equipment, giving medical suppliers with products in those facilities a license to charge whatever they want. If the insurance company does not pay their charges within 60 days, these companies have the right to apply a lien to the file and collect a late penalty plus interest. Requiring prior authorization for durable medical equipment, as we do for surgeries, will save payer-sources a considerable amount of money.
Second, the largest workers’ comp medical supply providers in California are from Florida,PMSI (Tampa), MSC (Jacksonville) and Tech Health (Tampa). These companies contract with California payer-sources, charge a network fee to provide supplies and then solicit local companies to carry out the delivery. These network fees are usually 30% to 50%.
I have worked on the payer side for a large insurance company, so I have seen these abuses first-hand. I started my own durable medical equipment company, because I knew that if we could implement a cost-containment solution for the payer-sources, we could not only make a good living, but we could make a difference for California companies.
Simply cutting out the network fee that the Florida based companies have been charging has allowed us to achieve 30%-plus savings for the State Compensation Insurance Fund, as well as other payer-sources.
I know it seems crazy that a supplier to the workers’ comp market is actually lobbying for tighter control on costs, but business owners in California need to work together.
Donald R. Woods
President
Experea Healthcare
Lake Forest
Ken Maddox
Orange County Supervisor Jim Silva recently announced that Assembly Member Ken Maddox, a candidate for the 35th State Senate District, is “unquestionably a solid fiscal conservative,” and that Maddox can be counted on to “continue to fight against increased regulation and higher taxes.”
In truth, Maddox has been significantly funded by labor unions since his first election to the State Assembly in 1998. Maddox’s voting record shows that he has consistently sold out whatever principles he once had to labor unions and their friends in the California State Legislature.
It is no surprise that Silva and his fellow Supervisor Chuck Smith have both endorsed Maddox. Both Silva and Smith joined former Supervisor Cynthia Coad in passing a countywide Project Labor Agreement during their mutual drive for the ill-fated El Toro commercial airport. The PLA was a quid pro quo agreement that was supposed to enlist the support of the county’s labor unions for the El Toro airport.
Last year Maddox took in over $60,000 from labor unions. Maddox returned their favors by voting for the eight-hour workday, prevailing wages, CEQA expansion, higher workers’ comp costs, increased litigation, forced union membership, raises for state employees and increased energy costs.
Art Pedroza
Orange County Representative
Coalition for Fair Employment in Construction
Jayson Blair
I thoroughly enjoyed Rick Reiff’s June 23 Notebook about the New York Times’ Jayson Blair scandal, “The Worst of Times.” He is right on target.
Nevena Orbach
The Orbach Company
Valley Glen
