Court Narrows Who Can Seek Recourse for Workers’ Comp Fee Disputes
- The Commonwealth Court of Pennsylvania ruled in Scomed Supply v. Hartford that only defined “providers” may initiate fee reviews.
- Scomed, an out-of-state billing agent, was ineligible to challenge reimbursement amounts because it did not treat the claimant.
- The court emphasized that the administrative remedy is restricted to those rendering professional healthcare services.
- This decision prohibits third-party entities from independently litigating fee disputes.
Court Rules Insurers Must Pay Interest on Delayed Workers’ Comp Fees
- A recent court decision clarified that insurance companies must pay interest and legal fees when they lose disputes over workers’ compensation payments.
- The case focused on an insurance group that successfully challenged underpayments but faced years of silence from state regulators regarding interest owed.
- The court ruled that this long delay counted as a final decision, allowing the insurer to collect. The ruling confirms that once a primary payment dispute is won, additional interest claims do not need to start the entire legal process over again.
Louisiana Bills Propose New Taxes and Regulations for Captive Insurance
- Proposed Louisiana legislation (HB 904, HB 932, and HB 936) could significantly impact businesses using captive insurance to manage workers’ compensation and liability risks.
- By imposing a 3% premium tax and stricter reserve requirements, these bills threaten to increase costs for alternative risk financing, particularly in the commercial trucking sector.
- Industry advocates argue these measures could discourage employers from using captives to efficiently fund their own workplace injury claims.
- If passed, the new rules would reverse recent efforts to modernize the state’s insurance market for high-risk industries.