april 30, 2008 quarterly report january, … la quinta benton 0.5 hospitality workplace violence...
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April 30, 2008
QUARTERLY REPORT January, February, March, 2008
The following, as required by Act 1179 of 1999, is a report of activity by the ArkansasWorkers' Compensation Commission' s Health and Safety Division and the Medical CostContainment Division.
HEALTH AND SAFETY DIVISION
Ark. Code Ann. §11-9-409, as amended by Act 796 of 1993, established the Workers’Compensation Commission’s Health and Safety Division to launch educational programs;collect injury data; identify hazardous employers; monitor their progress with follow-upinspections; and monitor accident prevention programs of insurance carriers.
MEDICAL COST CONTAINMENT DIVISION
The Medical Cost Containment Division (MCCD) was established pursuant to Ark. Code Ann.§11-9-517 (1987) and is responsible for the implementation, revision, and compliance ofCommission Rules 30, 33, and 34. Rule 30 consists of an inpatient and outpatient medical feeschedule. Rule 33 is our managed care rule, and Rule 34 refers to the Impairment RatingGuide.
Quarterly Report
Apr il 30, 2008
MEDICAL COST CONTAINMENT DIVISION
In the last quarter the following activities occurred regarding these rules:
Rule 30
Rule 30 was revised effective May 15, 2000. The AWCC adopted the Medicare RBRVSMedical Fee Schedule with Arkansas specific reimbursement multipliers. The new MedicalFee Schedule is available electronically from the AWCC Home Page. Since the Medical FeeSchedule is available electronically, we are no longer printing a medical fee schedule.
Administrative Review
Rule 30 contains an Administrative Review Process. This process allows providers orcarriers to request assistance from the Medical Cost Containment Division regarding disputes. Each administrative review requested consists of an investigation, desk audit by departmentstaff, and the issuance of an order, which determines the disputed issue. During this quarterthere were 31 review requests processed, 13 review requests granted, and 21orders issued. The ongoing issues in dispute consist of nonpayment, untimely payment, penalty request, andreimbursement disputes.
Balance Billing
Rule 30 also contains a prohibition against balance billing by providers. The balance billingprocess involves: receipt of an allegation of balance billing by a claimant, carrier, employer,self-insured, etc.; notice being sent to all involved parties; an investigation; an audit; and adetermination order being issued. During this quarter, the MCCD received “zero” balancebilling allegations.
Investigations
Investigations: There were 192 investigations conducted this quarter.
Quarterly Report
Apr il 30, 2008
Rule 33
We have 11 certified Managed Care Organizations.
Medical Reports
Medical Reports: As a result of a meeting held between the Chief Legal Advisor, the MedicalCost Containment Administrator, and the Chief Administrative Law Judge, the MCCD isobtaining medical records from the provider for carriers or employers that have been unable todo so. In the past the legal advisors would write to the provider requesting medical records. If the provider did not respond, then the Chief Administrative Law Judge would issue asubpoena in order to obtain the records. We thought perhaps there was another approach,especially since the MCCD staff has numerous medical contacts. We have thus far been ableto call the provider and obtain the records without any problems.
This quarter we received three (3) cases involving disputes about obtaining the medicalrecords.
Change of Physicians
Change of Physician: To expedite Change of Physician (COP) requests and to comply withrecent legislative changes, new procedures and policies have been implemented. COPrequests are sent to the Clerk of the Commission, who then forwards them to the MCCD forprocessing. If an AWCC file has been established, the MCCD calls the carrier/self-insuredemployer to determine if a Managed Care contract exists. This call is followed with a letterwhich is faxed and mailed to all parties. When a response is received and a contract exists,the contract is reviewed to determine if it complies with Rule 33 and if appropriate internalpolicies were followed. MCCD will review the claimant’s medical records and determine anappropriate provider. An appropriate provider will be chosen on a case-by-case basis. If therequest is to the claimant’s treating physician, MCCD must determine if the provider meets thestatutory requirements for the regular treating physician. Once an appropriate provider ischosen, MCCD will determine that the provider is a member of either the carrier/employer’sMCO , if a contract exists, or a certified MCO if no contract exists. MCCD will contact theprovider and set up an appointment for the claimant. MCCD will issue an order stating this isthe claimant’s one-time-only change of physician. This order will contain the provider’s nameand appointment date. All parties will be copied. If either party objects to the MCCD order,it can appeal to an Administrative Law Judge (ALJ).
This quarter the MCCD received 180 COP requests. MCCD issued 131 orders, and 53requests were either returned to open general files, withdrawn, controverted, resolved, orreturned to the Clerk of the Commission’s office for other action.
Quarterly Report
Apr il 30, 2008
Audits
Requests are received from the ALJ Division as well as outside entities (i.e. , caseworkers,attorneys, etc.) for medical bill audits.
This quarter the MCCD received and processed 12 audits.
Rule 34
Rule 34: There have been no changes at this time in Rule 34. Legislation was written toextend the legislative mandate regarding an impairment rating guide.
Speaking Engagements
Speaking Engagements: During this quarter no engagements/activities were attended.
Arkansas Workers’ Compensation CommissionHealth and Safety Division
3rd Quarter, FY 2008
During the 3rd Quarter, FY 2008, 12 fatalities were reported to the Arkansas Workers’ Compensation Commission.
BooneBenton Carroll
Marion
Baxter FultonRandolph
Clay
GreeneLawrence
Izard Sharp
Craighead Mississippi
Poinsett
Cross
Crittenden
St. Francis
Lee
Washington Madison
Newton Searcy
Stone
Jackson
Independence
CleburneVan Buren
Pope
JohnsonFranklin
Crawford
Sebastian Logan
ScottYell
Conway
Perry
Faulkner Woodruff
White
Prairie
Miller
Phillips
Monroe
LonokePulaski
Saline
GarlandMontgomeryPolk
Sevier
HowardPike
HempsteadLittle River
Lafayette
Clark
Nevada
Columbia
Grant
Dallas
Ouachita
Calhoun
Union
Jefferson
Cleveland Lincoln
Bradley
Drew
Ashley Chicot
Desha
ArkansasHot Spring
Workplace Fatalities Reported to AWCC
1
1
1
1
3
2
1
2
Workplace Fatalities by Quarter
0
5
10
15
20
25
30
FY
2003
FY
2004
FY
2005
FY
2006
FY
2007
FY
2008
1st Q
2nd Q
3rd Q
4th Q
ARC W orkplace Fatalities, FY Totals
0
20
40
60
80
100
2003 2004 2005 2006 2007 2008
FY
Workplace Fatalities Reported to AWCC
Arkansas Workers’ Compensation CommissionHealth and Safety Division
3rd Quarter, FY 2008
Rep. to
AWCC Employer
County of
Employer
Length of
Service
(yrs.) Type of Work Type of Injury
1/24/08 La Quinta Benton 0.5 Hospitality
Workplace violence
2/29/08 Christison Land Surveying, Inc. Benton 3.1 Service Struck by
1/31/08 Mendiola Bradley not given Forestry MVA
3/6/08 Trans Tech Consulting, Inc. Faulkner 1.0 Service Drowning
1/14/08 Knight, Inc. Mississippi 1.0 Oil & Gas Explosion
3/17/08 Maverick Tube Mississippi 0.3 Manufacturing Struck by
1/29/08 Mississippi Limestone Phillips 15.1 Construction Engulfment
2/7/08 Arkansas State Police Pulaski 27.2 Gov.; State MVA
2/15/08 Davis Transfer, Inc. Pulaski 1.7 Warehousing
Weather-related
3/26/08 Arthur's, LLC Pulaski not given Hospitality Fall
2/12/08 River Trailer, Inc. Van Buren 5.1 Manufacturing
Weather-related
2/14/08 Southwestern Energy Co. Washington
Died day of hire Oil & Gas MVA
During the 3rd Quarter, FY 2008, 94 places of employment were placed in the Rule 32 Program. Employers are identified for the Rule 32 Program if they have a higher-than expected number of compensable claims for their industry group. Employers placed in this program are encouraged to work with their workers’ compensation insurance carrier, in-house staff, or other professional safety sources to develop management tools which will help them run safer workplaces and minimize workers’ compensation costs through the use of such tools as return-to-work programs, drug-free workplace programs, claims management, etc.
BooneBenton Carroll
Marion
Baxter FultonRandolph
Clay
GreeneLawrence
Izard Sharp
Craighead Mississippi
Poinsett
Cross
Crittenden
St. Francis
Lee
Washington Madison
Newton Searcy
Stone
Jackson
Independence
CleburneVan Buren
Pope
JohnsonFranklin
Crawford
Sebastian Logan
ScottYell
Conway
Perry
Faulkner Woodruff
White
Prairie
Miller
Phillips
Monroe
LonokePulaski
Saline
GarlandMontgomeryPolk
Sevier
HowardPike
HempsteadLittle River
Lafayette
Clark
Nevada
Columbia
Grant
Dallas
Ouachita
Calhoun
Union
Jefferson
Cleveland Lincoln
Bradley
Drew
Ashley Chicot
Desha
ArkansasHot Spring
Employers Placed in the Rule 32 Program
Arkansas Workers’ Compensation CommissionHealth and Safety Division
3rd Quarter, FY 2008
3
1
1 1
1
1
1
1
2
2
2
1
1
2
4
7
1
4
5
1
1
1
1
1
1
6
1
1
6
4
26
2
2
2
2
2
2
The Accident Prevention Services (APS) group conducts audits of all insurance companies writingworkers’ compensation insurance policies in Arkansas. During the 2nd Quarter, FY 2008, the APS group inspected the following companies:
Rule 31: Accident Prevention Services ProgramArkansas Workers’ Compensation Insurance Companies
Arkansas Workers’ Compensation CommissionHealth and Safety Division
3rd Quarter, FY 2008
Company Account Premiums No. of PolicyholdersGray Insurance- Gray Casualty & Surety $555,165.00 13
Technology Insurance $1,084,547.00 328
Fireman's Fund Insurance - American Automobile
Insurance, American Insurance Company, Associated
Indemnity Corp., National Surety Corporation, Fireman's
Fund of Wisconsin $161,119.00 33
State Farm Insurance $2,125,356.92 1174
Capitol City Insurance $3,522,479.00 338
THE Insurance Co. $52,097.00 2
Southern Insurance $18,326.00 1
Amerisure Companies - Amerisure Mutual Insurance
Co., $3,819,084.00 170State Auto Insurance - State Auto Property and
Casualty Insurance Co., State Auto Mutual Insurance $2,276,072.00 527
Praetorian Insurance - Redland Iinsurance Co., Harbor
Specialty Insurance Company $5,008.00 4
During the 3rd Quarter, FY 2008, 46 employers successfully completed the Rule 32 Program.
Boone
Miller
Benton Carroll
Marion
Baxter FultonRandolph
Clay
GreeneLawrence
Craighead Mississippi
Poinsett
Cross
Crittenden
St. Francis
Lee
Phillips
Washington Madison
Newton Searcy
Stone
Izard Sharp
Jackson
Independence
CleburneVan Buren
Pope
JohnsonFranklin
Crawford
Sebastian Logan
ScottYell
Conway
Perry
Faulkner Woodruff
White
Monroe
LonokePulaski
Saline
GarlandMontgomeryPolk
Sevier
HowardPike
HempsteadLittle River
Lafayette
Clark
Nevada
Columbia
Grant
Dallas
Ouachita
Calhoun
Union
Jefferson
Cleveland Lincoln
Bradley
Drew
Ashley Chicot
Desha
Arkansas
Prairie
Hot Spring
2
1
Employers Completing the Rule 32 Program
Arkansas Workers’ Compensation CommissionHealth and Safety Division
3rd Quarter, FY 2008
1
1
2
3
3
11
11
1
3 2
2
1
1
1
1
11
1
2
4
1
1
1
1
1
3
3
The AWCC Health and Safety staff receive frequent requests to speak on a variety of topics related to loss control, drug-free workplace programs, and related topics. If your constituents would like to host a program by the Health and Safety staff on these or other subjects, please contact Patricia Burge at 501-682-2063 or [email protected].
BooneBenton Carroll
Marion
Baxter FultonRandolph
Clay
GreeneLawrence
Izard Sharp
Craighead Mississippi
Poinsett
Cross
Crittenden
St. Francis
Lee
Washington Madison
Newton Searcy
Stone
Jackson
Independence
CleburneVan Buren
Pope
JohnsonFranklin
Crawford
Sebastian Logan
ScottYell
Conway
Perry
Faulkner Woodruff
White
Prairie
Miller
Phillips
Monroe
LonokePulaski
Saline
GarlandMontgomeryPolk
Sevier
HowardPike
HempsteadLittle River
Lafayette
Clark
Nevada
Columbia
Grant
Dallas
Ouachita
Calhoun
Union
Jefferson
Cleveland Lincoln
Bradley
Drew
Ashley Chicot
Desha
ArkansasHot Spring
Presentations and Speaking Engagements
Arkansas Workers’ Compensation CommissionHealth and Safety Division
3rd Quarter, FY 2008
3
2
1
1
1
During the 3rd Quarter, FY 2008, the following Arkansas companies received approval of their Voluntary Drug Free Workplace Programs:
Voluntary Drug Free Workplace ProgramNew Approvals and Renewals
Arkansas Workers’ Compensation CommissionHealth and Safety Division
3rd Quarter, FY 2008
BooneBenton Carroll
Marion
Baxter FultonRandolph
Clay
GreeneLawrence
Izard Sharp
Craighead Mississippi
Poinsett
Cross
Crittenden
St. Francis
Lee
Washington Madison
Newton Searcy
Stone Independence
CleburneVan Buren
Pope
JohnsonFranklin
Crawford
Sebastian Logan
ScottYell
Conway
Perry
Faulkner Woodruff
White
Prairie
Miller
Phillips
Monroe
LonokePulaski
Saline
GarlandMontgomeryPolk
Sevier
HowardPike
HempsteadLittle River
Lafayette
Clark
Nevada
Columbia
Grant
Dallas
Ouachita
Calhoun
Union
Jefferson
Cleveland Lincoln
Bradley
Drew
Ashley Chicot
Desha
ArkansasHot Spring
15
4
1
1
2
6
3 Out of StateGrant
1
7
3
11
1
1
1
1
1
1
2
1
2
1
2
1
12
Jackson
22
26
11
4
6
6
3
Arkansas Workers’ Compensation CommissionHealth and Safety Division
3rd Quarter, FY 2008
Voluntary Drug Free Workplace ProgramNew Approvals and Renewals
COMPANY CITY COUNTYR.M. Courson, Inc. Hamburg ASHLEY
Petro-Mark, Inc. W.O. #9 Mountain Home BAXTERNabors Sanitation Mountain Home BAXTER
Petro-Mark, Inc. W.O. #23 Pea Ridge BENTONPetro-Mark, Inc. W.O. #28 Bentonville BENTONPetro-Mark, Inc. W.O. #32 Centerton BENTON
Central Group Rogers BENTONRed Rock Oil Field Hauling, LLC Rogers BENTON
Petro-Mark, Inc. W.O. #35 Rogers BENTONPetro-Mark, Inc. W.O. #36 Bentonville BENTON
Insul-Bead Corp. Gravette BENTONZero Mountain, Inc. Lowell BENTON
Diamond International Lowell BENTONClinard Construction Mgmt Bentonville BENTON
Dennis Electric, Inc. Rogers BENTONPel-Freez Arkansas, LLC Rogers BENTON
ACE Glass Company Lowell BENTONPetro-Mark, Inc. W.O. #2 Gas Harrison BOONE
Petro-Mark, Inc. W.O. #4 Harrison BOONEPetro-Mark, Inc. W.O. #7 Lead Hill BOONEPetro-Mark, Inc. W.O. #8 Harrison BOONEPetro-Mark, Inc. W.O. #15 Harrison BOONE
Petro-Mark, Inc. W.O. #15 Subway Harrison BOONEPetro-Mark, Inc. W.O. #15 Depot Harrison BOONE
Petro-Mark, Inc. W.O. #16 Harrison BOONEPetro-Mark, Inc. W.O. #25 Bergman BOONEPetro-Mark, Inc. W.O. #26 Harrison BOONE
Petro-Mark, Inc. W.O. #77 Subway Lead Hill BOONEPetro-Mark, Inc. W.O. #29 Berryville CARROLL
S.W.T., Inc. Green Forest CARROLLJ.W. Black Lumber Co. Corning CLAY
Sound-Craft Systems, Inc. Morrilton CONWAYCrow Paving, Inc./Jay-Pac,Inc. Morrilton CONWAYConsolidated Youth Services Jonesboro CRAIGHEAD
Tate General Contractors, Inc. Jonesboro CRAIGHEADJ. T. White Lumber Co., LLC Jonesboro CRAIGHEAD
RGB Mechanical Contractors, Inc. Jonesboro CRAIGHEADInnovative Interiors, Inc. Jonesboro CRAIGHEAD
SignSystems, Inc. Jonesboro CRAIGHEADCity Water & Light Jonesboro CRAIGHEAD
Dillmeier Enterprises, Inc. Van Buren CRAWFORDMahar Manufacturing Van Buren CRAWFORD
Roeder Construction Co., Inc. Marion CRITTENDENDayco Construction Damascus FAULKNER
Fortier Inc. Conway FAULKNERNBMC, Inc. Greenbrier FAULKNER
Hugg and Hall Equipment Conway FAULKNERDiamond State Bus Company Conway FAULKNER
Lock-Wood Electric , Inc Conway FAULKNERChrisman Ready-Mix, Inc. Ozark FRANKLINPetro-Mark, Inc. W.O #5 Salem FULTON
Arkansas Workers’ Compensation CommissionHealth and Safety Division
3rd Quarter, FY 2008
Voluntary Drug Free Workplace ProgramNew Approvals and Renewals
COMPANY CITY COUNTYPetro-Mark, Inc. W.O. #55 Subway Salem FULTON
Alliance Rubber Co. Hot Springs GARLANDGTS Construction Inc. Hot Springs GARLANDQuapaw House, Inc. Hot Springs GARLAND
Allen Engineering Corp. Paragould GREENEDiamond International Pine Bluff JEFFERSON
Underground Utilities Contractors, Inc. Cabot LONOKEPetro-Mark, Inc. W.O. #13 Subway Yellville MARION
Hugg and Hall Equipment Texarkana MILLERTim Jordan Co. Inc. Camden OUACHITA
Hugg and Hall Equipment Camden OUACHITAD&D Forestry, Inc. Camden OUACHITAProducers Tractor Helena PHILLIPSF.M. DIX Co. Inc. Mena POLK
Brodix, Inc. Mena POLKP.O.M. Inc. Russellville POPE
Zero Mountain, Inc. Russellville POPEKirby Specialties Corp. Russellville POPEDiamond International Russellville POPEVan Horn Construction Russellville POPEVan Horn Construction Russellville POPE
Handling Systems & Conveyor Mabelvale PULASKIHugg and Hall Equipment Little Rock PULASKIDemocrat Printing & Litho Little Rock PULASKI
Improved Construction Methods, Inc. Jacksonville PULASKIChiefseahawk Transport LLC Little Rock PULASKI
Bailey Properties, LLC Little Rock PULASKICoulson Oil Group North Little Rock PULASKI
Custom Aircraft Cabinets North Little Rock PULASKIHeslep Concrete Co. Little Rock PULASKIPPS Inc. EasyCash 1 Little Rock PULASKIDiamond International North Little Rock PULASKIParkway Automotive Little Rock PULASKI
Beard-Breeding Painting Mabelvale PULASKIPPS Inc., DBA Braswell & Son Little Rock PULASKI
ACE Glass Company Little Rock PULASKIRodebush Construction, Inc. Fort Smith SEBASTIAN
Carman, Inc. Fort Smith SEBASTIANHugg and Hall Equipment Fort Smith SEBASTIAN
Bradley Machine Fort Smith SEBASTIANZero Mountain, Inc. Fort Smith SEBASTIAN
Blaylock Heating & Air Conditioning Ft. Smith SEBASTIANTri-Lakes Services, Inc. Gillham SEVIER
Petro-Mark, Inc. W .O. #31 Hardy SHARPPetro-Mark, Inc. W.O. 66 Subway Hardy SHARP
Hugg and Hall Equipment El Dorado UNIONEl Dorado Foundry Machine and Supply Co., Inc. El Dorado UNION
Arkansas Workers’ Compensation CommissionHealth and Safety Division
3rd Quarter, FY 2008
COMPANY CITY COUNTYMangum Contracting, Inc. El Dorado UNIONPetro-Mark, Inc. W.O. #12 Fayetteville WASHINGTONPetro-Mark, Inc. W.O. #14 Fayetteville WASHINGTON
Petro-Mark, Inc.W.O. #27 Elect. Springdale WASHINGTONPetro-Mark, Inc. W.O. #34 Fayetteville WASHINGTONHugg and Hall Equipment Fayetteville WASHINGTONHugg and Hall Equipment Springdale WASHINGTON
The Potty House Inc. Fayetteville WASHINGTONZero Mountain, Inc. Johnson WASHINGTON
Budgetext Corporation Fayetteville WASHINGTONHeartland Honda Springdale WASHINGTON
Basic Block Group LLC Springdale WASHINGTONJohnson Mechanical Contractors, Inc. Fayetteville WASHINGTON
Arkansas Occupational Medicine Services Springdale WASHINGTONAdvanced Records Storage, Inc. Springdale WASHINGTON
D&H Electrical Cont. Inc. Searcy WHITEPetro-Mark, Inc. W.O. #10 Branson OUT OF STATEPetro-Mark, Inc. W.O. #11 Branson OUT OF STATE
Southeastern Property Management Birmingham OUT OF STATE
Voluntary Drug Free Workplace ProgramNew Approvals and Renewals