The DIR should thank the FBI for investigating CA State Senator Calderon, as the decrease in costs associated with spinal surgeries is directly linked to the investigation into Michael Drobot’s two Southern CA facilities (Drobot was Calderon’s largest campaign contributors, but has now agreed to testify against the Senator). I don’t believe that the DIR is doing nearly enough to reduce costs. And their cheerleading for SB 863 is ludicrous, considering that the Insurance Industry wasn’t even invited to the table when the Legislation was being drawn up. Undoubtedly, SB 863 will blow up, be found to be unconstitutional, and the Legislature will have to go back to the drawing board. When this occurs, I pray that an ethical Legislator will carry a well-crafted bill, one that includes all sides at the table, including the Ins Industry.
So the homely witch of the North cites a report that says that 95% of the treatment requests have survived UR and IMR. This has to be one of the biggest lies that has ever been told. An infamous Third Reich propaganda minister ounce said: “there is no lie that works better than the big lie”. We on the applicant’s side know this garbage is untrue and frankly a bolt of lightening is likely to show up soon for Ms. Baker for her despicable lies.
863 was a payoff to business interests so they would not place attack ads against Prop 30, the tax increase proposition in 2013. The business community was at that time agitating for tax decreases. Brown and his socialists who had moved so far to the left that the average working person who had done well was viewed by the lefty’s as being closer to the 1 per cent than the welfare moms, drug addicts, homeless,prisoners, illegal aliens and other non-contributing types they had come to support. So, what did they do? The lefty’s sold out the working person to keep the taxes rolling in. Think about it, someone had to be used as barter.
We would never have had SB899 or SB863 without the Democrat’s votes. The Republicans could never have done it without such help.
Now, for the real reason the Democrats stuck us with 863. For years (maybe as many as 40 years worth) there has been an ocean of open medical claims that were not compromised and released. These claims represent a debt owed to various former and present employees. As medical costs were rising and the need for a massive tax increase became necessary, Brown had to figure out a way to get it. So, in 2013 he got his henchmen together and crafted one of the most disingenuous, fraudulent and crushing bills injured worker bills ever produced.
Seeing this sea of prior awards, Brown sent a message to business interests that he could put a lot of money back in their pockets if they could see their way clear to help him get a tax increase. The idea behind 863 was pure genius. By taking away a worker’s right to appeal a treatment denial from the lawyers and judges the cost of medical care would drop significantly and Brown could literally guarantee any future result. The sea of open claims (billions of dollars) would be devalued due to the fact that Brown and his buddies would be able to deny most medical treatment without recourse by the victims. Please note that the self-insured and public entity folks can now invest their reserves. This is because the need for the reserves is substantially less since IMR can refuse treatment requests without recourse. Please also note that the change was made last year but actual investment could not occur until a few days ago. This was because Brown had to wait to see if his plan was working before the parties could start investing those reserves.
Well, IMR is alive and well. Every IMR case involving my office has been in favor of a UR denial amounting to hundreds of people going without treatment. Additionally, I can guarantee that the Brown economic team is hammering the Board Commissioners on Dubon as I write. I predict (and I hope I am wrong!) that Dubon will go down in flames and it will do so because the commissioners have been informed by the Brown People that a change is necessary.
Lastly, think about those pesky MSA’s. If UR and IMR deny treatment is it appropriate to place those costs in the MSA? Well the Feds may require it but you can bet some state government geek somewhere is working on this to try to use SB863 to accomplish the reduction. In serious cases the cost of an MSA could be 500 grand with half of that being medications. UR is routinely doing wholesale denials of all pain medication even in cases where the applicant had been receiving it for some time. The UR report is then sent to the IMR and presto! The expensive medications are history with no recourse.
Brown needs to feel the heat. He needs to know that there are people who know what he has done and whom he has done it with. I understand that he needed some Christians to throw to the lions but picking those that actually contribute in favor of the non-producers must spell doom at some point. Some of those liberals that applicant attorneys routinely support must be sacrificed in order to send the message that injured workers are not a bargaining chip so that prisoners can have more comfy quarters. Or maybe not.
Bob you are totally correct – I see almost every request initially denied and sadly not for whether or not it is supported by EBG but because the non-medical person reading it doesn’t find that it has all the proper forms – this delays the case and when appealed they then authorize it. But, it has been 2-3 months of delays each time an MRI or EMG/NCS or PT is requested. Very often these companies are corrupt and they guarantee employers a certain amount of denials percentage wise. Then, this has to go back to the adjuster who may or may not override. In the long run care is denied for so long that when it is allowed 6 months to 2 years have passed. This makes it very contentious.
The DIR should thank the FBI for investigating CA State Senator Calderon, as the decrease in costs associated with spinal surgeries is directly linked to the investigation into Michael Drobot’s two Southern CA facilities (Drobot was Calderon’s largest campaign contributors, but has now agreed to testify against the Senator). I don’t believe that the DIR is doing nearly enough to reduce costs. And their cheerleading for SB 863 is ludicrous, considering that the Insurance Industry wasn’t even invited to the table when the Legislation was being drawn up. Undoubtedly, SB 863 will blow up, be found to be unconstitutional, and the Legislature will have to go back to the drawing board. When this occurs, I pray that an ethical Legislator will carry a well-crafted bill, one that includes all sides at the table, including the Ins Industry.
So the homely witch of the North cites a report that says that 95% of the treatment requests have survived UR and IMR. This has to be one of the biggest lies that has ever been told. An infamous Third Reich propaganda minister ounce said: “there is no lie that works better than the big lie”. We on the applicant’s side know this garbage is untrue and frankly a bolt of lightening is likely to show up soon for Ms. Baker for her despicable lies.
863 was a payoff to business interests so they would not place attack ads against Prop 30, the tax increase proposition in 2013. The business community was at that time agitating for tax decreases. Brown and his socialists who had moved so far to the left that the average working person who had done well was viewed by the lefty’s as being closer to the 1 per cent than the welfare moms, drug addicts, homeless,prisoners, illegal aliens and other non-contributing types they had come to support. So, what did they do? The lefty’s sold out the working person to keep the taxes rolling in. Think about it, someone had to be used as barter.
We would never have had SB899 or SB863 without the Democrat’s votes. The Republicans could never have done it without such help.
Now, for the real reason the Democrats stuck us with 863. For years (maybe as many as 40 years worth) there has been an ocean of open medical claims that were not compromised and released. These claims represent a debt owed to various former and present employees. As medical costs were rising and the need for a massive tax increase became necessary, Brown had to figure out a way to get it. So, in 2013 he got his henchmen together and crafted one of the most disingenuous, fraudulent and crushing bills injured worker bills ever produced.
Seeing this sea of prior awards, Brown sent a message to business interests that he could put a lot of money back in their pockets if they could see their way clear to help him get a tax increase. The idea behind 863 was pure genius. By taking away a worker’s right to appeal a treatment denial from the lawyers and judges the cost of medical care would drop significantly and Brown could literally guarantee any future result. The sea of open claims (billions of dollars) would be devalued due to the fact that Brown and his buddies would be able to deny most medical treatment without recourse by the victims. Please note that the self-insured and public entity folks can now invest their reserves. This is because the need for the reserves is substantially less since IMR can refuse treatment requests without recourse. Please also note that the change was made last year but actual investment could not occur until a few days ago. This was because Brown had to wait to see if his plan was working before the parties could start investing those reserves.
Well, IMR is alive and well. Every IMR case involving my office has been in favor of a UR denial amounting to hundreds of people going without treatment. Additionally, I can guarantee that the Brown economic team is hammering the Board Commissioners on Dubon as I write. I predict (and I hope I am wrong!) that Dubon will go down in flames and it will do so because the commissioners have been informed by the Brown People that a change is necessary.
Lastly, think about those pesky MSA’s. If UR and IMR deny treatment is it appropriate to place those costs in the MSA? Well the Feds may require it but you can bet some state government geek somewhere is working on this to try to use SB863 to accomplish the reduction. In serious cases the cost of an MSA could be 500 grand with half of that being medications. UR is routinely doing wholesale denials of all pain medication even in cases where the applicant had been receiving it for some time. The UR report is then sent to the IMR and presto! The expensive medications are history with no recourse.
Brown needs to feel the heat. He needs to know that there are people who know what he has done and whom he has done it with. I understand that he needed some Christians to throw to the lions but picking those that actually contribute in favor of the non-producers must spell doom at some point. Some of those liberals that applicant attorneys routinely support must be sacrificed in order to send the message that injured workers are not a bargaining chip so that prisoners can have more comfy quarters. Or maybe not.
Bob
Bob you are totally correct – I see almost every request initially denied and sadly not for whether or not it is supported by EBG but because the non-medical person reading it doesn’t find that it has all the proper forms – this delays the case and when appealed they then authorize it. But, it has been 2-3 months of delays each time an MRI or EMG/NCS or PT is requested. Very often these companies are corrupt and they guarantee employers a certain amount of denials percentage wise. Then, this has to go back to the adjuster who may or may not override. In the long run care is denied for so long that when it is allowed 6 months to 2 years have passed. This makes it very contentious.
Woman is completely out of touch with reality.