Review Shows Denial of North Carolina Frontline Employees’ Workers’ Comp Claim

• A review of North Carolina and city of Charlotte pandemic workers’ comp claims reveas most who apply for benefits are getting denied, including some frontline employees.

• State records show North Carolina has only paid COVID workers’ comp to seven out of the 35 employees whose claims went to its third-party administrator.
• Public records show the city of Charlotte has used federal COVID-19 money to compensate nearly 600 employees a combined $515,000. Water, fire and police employees had the highest total amount of claims paid and received 94% of all money paid out.
• Statewide, data through August 31, 2021, show 63% of employees (government and non-government) who filed pandemic-related claims in North Carolina were denied.

 

SCOTUS Considering Certiorari In Workers’ Comp Medical Cannabis Cases

• Medical cannabis is being legalized in an increasing number of states, which will have an impact on a variety of employment issues, including workers’ compensation, writes attorney Nicole Mayo. The Supreme Court appears to be considering providing clarity to employers and employees regarding payment in workers’ comp claims.

• In February, the Supreme Court requested the Solicitor General submit an amicus brief regarding whether a workers’ compensation insurer paying for an injured employee’s medical cannabis is a violation of federal law.
• If the Supreme Court grants certiorari and makes a ruling, it could impact employers nationwide: currently, 37 states allow the use of medical marijuana..

 

Philadelphia Psychiatrist to Pay $3M to Resolve Allegations of False Workers’ Comp Claims

• The US Attorney’s office has announced a Philadelphia psychiatrist and his wife have agreed to pay a total of $3 million to resolve alleged violations of the False Claims Act.
• Dr. Harry Doyle, a psychiatrist to whom an attorney referred patients receiving federal workers’ compensation benefits authorized under the Federal Employees Compensation Act is charged with submitting false billing to the U.S. Department of Labor Office of Workers’ Compensation Programs for psychiatric services that were not provided, as well as upcoding and double-billing patient claims.

• A multi-agency investigation revealed that from 2013 through part of 2021, the Doyles allegedly billed for services not rendered, some of which occurred when the Doyles were not physically present in the US.

 

Second Doctor Pleads Guilty to Workers’ Comp Fraud Conspiracy

• An Alexandria, Louisiana physician has pleaded guilty to conspiring to violate three federal statutes in connection with a scheme to defraud federal and private workers’ compensation insurers.
• The basic premise of the alleged scheme, which ran from 2013-17, was that people associated with an Arkansas-based medical supply and billing company recruited the physician to dispense pain creams and patches to workers’ comp patients by offering him a split of the profits.

Montana State Fund Announces Rate Reduction, $40M Dividend

• Montana State Fund, the state’s largest workers’ compensation insurance company, recently announced a 3% average rate reduction for its policyholders, the 16th consecutive year MSF rates have remained flat or been reduced, according to the agency.
• MSF’s rates are now 54.1% lower than in 2006, the year of the last rate increase, officials say.
• In October, Montana State Fund announced a record-tying $40 million dividend for policyholders.