 |
We’re already hard at work planning the sessions for the 2013 Conference. For now, you can see in the 2012 agenda the quality and variety of sessions offered every year. |
 2012 Agenda
|
View the agenda by
date or by track. |
Tuesday, Nov. 6, 2012
|
|
Wednesday, Nov. 7, 2012
|
2012 Program Tracks |
Better Claims
Management |
Health/Medical Management |
Solving Legal/Regulatory Issues |
Opioid
Solutions |
Schedule subject to change. |
Thursday, Nov. 8, 2012
|
2012 Program Tracks |
Better Claims
Management |
Health/Medical Management |
Solving Legal/Regulatory Issues |
Opioid
Solutions |
Schedule subject to change. |
Friday, Nov. 9, 2012
|
2012 Program Tracks |
Better Claims
Management |
Health/Medical Management |
Solving Legal/Regulatory Issues |
Opioid
Solutions |
Schedule subject to change.
[back to top] |
|
|
Pre-Conference Symposium
Workers’ Compensation Essentials for Executives and Risk Professionals
Pamela F. Ferrandino, Casualty Practice Leader, Placement, Willis North America, New York
Katrina Zitnik, Director of Workers' Compensation, Costco Wholesale, Seattle
Shannon Gardner, Senior Manager, Risk Management, Chick-fil-A, Inc., Atlanta
Denise Gillen-Algire, RN, Practice Leader, Integrated Health & Productivity, Risk Navigation Group,
Albuquerque, N.M
Jim Pocius, Shareholder, Marshall, Dennehey, Warner, Coleman & Goggin, Philadelphia
Treasa Turnbeaugh, Chief Executive Officer, Board of Certified Safety Professionals,
Urbana-Champaign, Illinois
Moderator: Mark Noonan, Managing Principal, Casualty Practice, Integro Insurance Brokers, Boston
Economic realities have forced many high-level executives to take on workers’ comp responsibilities for their organizations. CFOs, general counsels, and risk professionals with purchasing authority are suddenly tasked with overseeing a system they may understand only peripherally. This half-day program is designed to provide these high-level professionals a core understanding of workers’ compensation and the tools needed to design, price and manage a successful workers’ compensation program. Among the topics covered by our faculty of leading workers’ compensation experts will be:
• Workers’ compensation’s origins, current status and challenges.
• Pre-loss programs and how to build them.
• How to price a program, including the impact of losses on experience modifications.
• Medical components of an effective workers’ compensation program.
• Claims management and vendor management tips.
• Management information sharing — what to share with whom, when and how.
• The challenges of litigation.
Pre-conference symposium requires separate registration and fee.
[back to top]
Opening General Session
Intriguing Insights: Leaders Debate Solutions to Industry’s Top Challenges
Dr. Jennifer Christian, Founder and Lead Maze-Masters Guide, Maze-Masters Program; President, Webility
Corporation, Wayland, Mass.
Jill Dulich, Senior Director, Marriott Claims Services, Los Angeles
Maureen Gallagher, Managing Director, Neace Lukens, Southfield, Mich.
John Leonard, President and CEO, Maine Employers’ Mutual Insurance Company, Portland, Maine
Dave North, CEO, Sedgwick, Memphis, Tenn.
Moderator: Mark Walls, Vice President, Claims, Safety National, St. Louis
Wednesday, Nov. 7 | 8:30 - 10 a.m.
Six of the industry’s top leaders representing the employer, medical, TPA, insurance and broker communities will kick off the conference in a spirited debate. Each of these highly respected – and opinionated panelists – will share and share what they think are the best solutions to two of the biggest challenges in the workers’ compensation/disability systems, to be determined pre-conference by a poll of the 15,000-member WorkCompAnalysis Group on LinkedIn. Listen to the experts. Ask questions. Leave energized with concrete ideas to tackle the biggest obstacles you face and the best solutions for you.
[back to top] |
Return-to-Work: Has Yesterday’s Asset Become Today’s Liability? CM1
Richard Pimentel, Senior Partner, Milt Wright & Associates, Granada Hills, Calif.
Wednesday, Nov. 7 | 10:45 a.m. - 12 p.m.
Are return-to-work programs relevant – and feasible – in today’s employment climate? Many employers now consider hiring a fully able-bodied person to handle multiple jobs, rather than transitioning an injured worker to a light-duty position. Richard Pimentel, one of the nation’s leading experts on return-to-work and disability management, will conduct a step-by-step evaluation of the RTW process, including the legal ramifications of the ADAAA, to help employers understand whether and how to modify their RTW programs.
Session takeaways
- Understand the potential cost savings of RTW programs
- Learn a process to critically evaluate the effectiveness of RTW programs
- Establish methods to modify RTW programs to meet the current economic and legal realities
[back to top] |
Pain Forensics: Finding Missed Opportunities for Positive Outcomes HM1
Fernando Branco, M.D., Medical Director, Rosomoff Comprehensive Pain Center, Miami
Steven Moskowitz, M.D., Senior Medical Director, Paradigm Management Services, Walnut Creek, Calif.
Wednesday, Nov. 7 | 10:45 a.m. - 12 p.m.
Chronic pain claims are sapping the resources of many claims managers. With so many challenges involved in these cases, they can be difficult to effectively manage. Two medical specialists will deconstruct a workers’ comp pain case step-by-step and identify the missteps made as well as how the claim could have been handled differently. You’ll learn the specific actions and missed opportunities that contributed to poor outcomes and find out how to manage pain cases to achieve the best clinical outcomes for injured workers and employers.
Session takeaways
- Understand the difference between correctly managed and mismanaged pain cases in terms of costs, outcomes and satisfaction
- Learn the benefits of an early intervention process to manage pain claims
- Set strategies to lower overall pain claim costs and case reserves
- Determine how to deconstruct cases to uncover areas for improvement.
[back to top]
Breaking the Web of Needless Disability HM2
Robert Aurbach, CEO, Uncommon Approach, Inc.; Editor, Journal of the International Association of
IndustrialAccident Boards and Commissions; former General Counsel, New Mexico Workers’ Compensation Administration
Wednesday, Nov. 7 | 10:45 a.m. - 12 p.m.
Why do a handful of claims eat up the majority of your resources? According to Mr. Aurbach, there is a scientific reason that some claims turn into permanent disability cases, but once understood, they can be prevented. A highly respected researcher and former regulator, Robert Aurbach has extensively studied neuroscience to create a model of the acquisition of learned disability behavior. He’ll teach you a unique, broad-based intervention that incorporates a claimant’s perceived loss of control, the medicalization effects of the loss of identity, attorney impacts, and psychosocial flags – to recognize and prevent needless disability.
Session takeaways
- Understand how intervention strategies can be more cost-effective in preventing unnecessary disability than cost-reduction efforts
- Become versed in the neuroplasticity model of acquired disability behavior
- Develop strategies to reduce the number of problematic claims
- Acquire coping tips to give claimants so they stay on track toward recovery
[back to top] |
Legal Triage: Team-Based Early Case Management to Fast-Track Claims LR1
Marianne Cloeren, M.D., Medical Director, Managed Care Advisors, Inc., Bethesda, Md.
Thomas Glimp, M.D., Chief Medical Officer, Medcor, Inc., McHenry, Ill.
Donna O’Keefe, RN, CSL Behring, Bradley, Ill.
Rebecca Shafer, J.D., President, Amaxx Risk Solutions, Inc., Hartford, Conn.
Moderator: Brad Bleakney, Esq., Bleakney & Troiani, Chicago.
Wednesday, Nov. 7 | 10:45 a.m. - 12 p.m.
Legal triage is a value-added service from defense attorneys that can reduce costs for employers and improve outcomes for the injured. The process starts with the initial claim investigation and moves to more thorough investigation of borderline cases before an initial determination is made. This panel of respected legal and medical professionals will explain how greater collaboration and communication by all parties early in the claims process can benefit everyone.
Session takeaways
- Learn early intervention methods based on a team approach involving risk, medical and defense
- Find out why the first 30 days is the window of opportunity
- Discover how early acceptance or denial leads to decreased lawyer participation and lower loss runs
- Learn how early medical management decreases overall medical expense and limits lost time incurred
[back to top] |
Opioid Addiction: The Causes, Costs and Solutions OS1
Gary Franklin, M.D., Medical Director, Washington Department of Labor and Industries, Seattle
Sanford M. Silverman, MD, PA, Director, Comprehensive Pain Medicine, Founding Partner,
Lorsand Continuing Medical Education, LLC, Pompano Beach, Fla.
Moderator: Joe Paduda, Principal, Health Strategy Associates, and ManagedCareMatters blogger,
Madison, Conn.
Wednesday, Nov. 7 | 10:45 a.m. - 12 p.m.
It’s here. It’s real. And most payers are not yet taking it seriously. Those are among the uncomfortable truths about opioid addiction in the workers’ comp system. The impact is just beginning to be understood and what’s being revealed is “quite disturbing,” say members of this prestigious panel of experts. This session will offer a template for a comprehensive payer-specific approach and reveal the very latest state guidelines and their effectiveness.
Session takeaways
- Explain the costs of prescription drug addiction
- Understand what addiction withdrawal looks like
- Learn guidelines for weaning a claimant off opioids
- Examine the price of treating – and not treating – addicts
- Understand the approach the state of Washington has taken and its outcomes
[back to top] |
Wednesday, Nov. 7 | 12 - 1:45 p.m.
Meet the winners of Risk & Insurance® magazine's 2012 Theodore Roosevelt Workers’ Compensation and Disability Management Awards, honoring organizations that are setting the bar for the industry.
|
 |
Awards Luncheon & Entertainment
|
Sponsored by:
 |
Also meet this year’s PreVent Award winners, being honored for their devotion of significant time and resources to develop and implement proactive strategies to prevent workplace injuries. |
|
Experience the Extraordinary!
Craig Karges
Tables float, minds are read and metal bends. Craig Karges takes mystery entertainment to a whole new level to prove that nothing is impossible! Claiming to be an entertainer not a psychic, he challenges the imagination by combining the art of magic with the science of psychology and the power of intuition – and leaves audiences mystified. |
|
|
From Hire to Retire: Battling Leakage in the War on Cost Management CM2
Kathy Kukor, Senior Consultant, Risk International Services, Inc., Charlotte, N.C.
Wednesday, Nov. 7 | 2:30 - 3:45 p.m.
The best way to lower workers’ comp costs is to prevent injuries and illnesses in the first place. Therefore, cost management strategies should begin in the hiring phase and continue potentially through retirement. The key is to gain input from all parties involved – from supervisors and HR to those who ultimately manage workers’ comp claims. Working as a team, you can develop screening practices that focus on job suitability to help avoid hiring an employee prone to be the next workers’ comp claim. If a claim does arise, your team will be positioned to manage it quickly, efficiently, and cost-effectively.
Session takeaways
- Explain the cost management process pre- and post-loss
- Explore common areas of cost management leakage and why they occur
- Facilitate a better understanding of the roles and responsibilities of all involved in the hiring and workers’ comp management processes
[back to top]
Think Tank on Medicare Issues Related to Workers’ Compensation CM3
Facilitator: James Pocius, Shareholder, Marshall, Dennehey, Warner, Coleman & Goggin, Philadelphia
Wednesday, Nov. 7 | 2:30 - 3:45 p.m.
This open forum offers you a unique opportunity to discuss Medicare-related challenges and solutions with your peers. An advanced practicum for discussing issues, strategies, goals and ideas, the think tank allows you to brainstorm with other workers’ comp professionals. Whether it relates to Medicare secondary payer recovery contracts or Medicare setasides, you will have a safe harbor to learn what others are doing. The facilitator will help analyze critical problems and seek consensus for innovative solutions to address Medicare-related issues.
Session takeaways
- Understand the obstacles facing your peers with respect to Medicare issues.
- Gain feedback from other professionals on your strategic plans.
[back to top] |
Building a Better Medical Network
HM3
Monica Lichtenstein, Director, Claims Operations, Aramark, Philadelphia
Patrick Venditti, Director, BJC Corporate Health Services, BJC HealthCare, St. Louis
Anita Weir, Director, Medical and Disability Management, Safeway, San Francisco
Moderator: Mark Walls, VP-Claims, Safety National, St. Louis
Wednesday, Nov. 7 | 2:30 - 3:45 p.m.
Better outcomes for injured workers lead to lower workers’ comp expenditures. Many employers are discovering that focusing on quality medical care, rather than pricing, saves more money in the long run. If you are looking to ramp up the quality of your medical networks, come hear from three employers who did just that by looking at their claims, talking to case managers and interviewing physicians to ultimately build their own networks.
Session takeaways
- Understand how quality medical care can lower workers’ comp costs
- Understand the step-by-step process to build a medical network
- Learn what you need to measure to determine success
[back to top] |
The Future of Exclusive Remedy LR2
Albert Betts, Esq., Thompson Coe Cousins & Irons, LLP, Austin, Texas
Kevin L. Connors, Esq., ConnorsLaw LLP, Exton, Pa.
Lex K. Larson, President, Employment Law Research Inc., Durham, N.C.
Lawrence J. Pascal, Esq., Ashcraft & Gerel, LLP, Alexandria, Va.
Moderator: Thomas A. Robinson, J.D., Author, Durham, N.C.
Wednesday, Nov. 7 | 2:30 - 3:45 p.m.
Is the exclusivity defense disappearing? Anecdotal reports indicate it is clearly under attack. Our distinguished panel will examine whether dual capacity/persona claims, expansion of the “substantial certainty” rule related to intentional torts, RICO actions filed against employers, actions filed under disparate provisions such as Florida's Water Quality Assurance Act, and wrongful death claims by non-dependent parents spell the doom of an important part of the employer's workers’ comp bargain. The answers may surprise you.
Session takeaways
- Examine the “evidence” of the attack on exclusive remedy, based on specific court decisions
- Identify actions that are seemingly undermining the defense and how to prevent them
- Learn steps to ensure that employers don’t lose the exclusive remedy defense
[back to top]
Medical Treatment Issues: A Comparison of Jurisdictional Differences LR3
Hon. Colleen S. Casey, Workers’ Compensation Administrative Law Judge, San Francisco
Richard M. Jacobsmeyer, Esq., Shaw, Jacobsmeyer, Crain & Claffey, LLP, Oakland
Martin Klug, Esq., Huck, Howe & Tobin, St. Louis
Cassandra Roberts, Esq., Young Conaway Stargatt & Taylor, LLP, Wilmington, Del.
Moderator: Robert G. Rassp, Esq., Law Office of Robert G. Rassp, Sherman Oaks, Calif.
Wednesday, Nov. 7 | 2:30 - 3:45 p.m.
Utilization review has become a cost driver in the workers’ comp system. Is it worth it? What about the unintended consequences of strict UR, such as injured workers seeking medical treatment outside the comp system or retaining legal counsel when UR is denied or modified? How do different jurisdictions cover UR, as well as standard of care? Get the answers from this panel of prestigious attorneys and a workers’ compensation judge.
Session takeaways
- Understand different jurisdictional statutes and regulators of medical treatment issues
- Indentify the unintended consequences of some of the regulations and statutes and how to avoid them
- Understand the pros and cons of UR in the workers’ comp system
[back to top] |
Opioids and Workers’ Comp: What the Latest Data Shows Us OS2
Steven Feinberg, M.D., Chief Medical Officer, American Pain Solutions, Palo Alto, Calif.
Alex Swedlow, EVP, Research & Development, California Workers’ Compensation Institute, Oakland
Wednesday, Nov. 7 | 2:30 - 3:45 p.m.
Inappropriate or excessive use of opioids delays recoveries and drives up costs. Claimants receiving the highest dosage levels had 200 percent higher medical costs than claimants receiving lower dosages, according to groundbreaking research in 2010 that first alerted workers’ comp stakeholders to the potential extent of the problem. Lead researcher Mr. Swedlow teams up with renowned pain medicine specialist Steven Feinberg to present the latest trends in the explosive use of narcotics in the workers’ comp system. They’ll show you how to balance the needs of workers in pain with the inappropriate use of the drugs, and give you strategies to work with physicians for the best outcomes.
Session takeaways
- Understand the changing nature of opioids in pain management intervention
- Provide current opioid use guidelines
- Learn what is appropriate versus what is inappropriate in the use of opioids
[back to top] |
|
A Blueprint for Successful High-Exposure Claims Closures CM4
Barry Bloom, Consultant, The bdb Group, San Carlos, Calif.
Suzanne Guyan, Director of Product Development, CompPartners, Inc, Calif.
Cathey Jackson, Director, Workers' Compensation Vons, A Safeway Company, Arcadia, Calif.
Thursday, Nov. 8 | 8:45 - 10 a.m.
High-dollar workers’ comp claims typically generate complex and contentious issues. But by getting key stakeholders together you can fend off many of the hurdles. That’s the idea behind a concept developed by William Zachry and Barry Bloom which is being increasingly utilized in high-risk claims. Dubbed “The Double Play,” it brings claims, legal and medical stakeholders together in a roundtable triage to strategically discuss the issues and develop solutions. Stakeholders won’t want to miss the chance to learn about this hands-on tool to identify, select, develop and manage your team to resolve high-exposure cases.
Session takeaways
- Find ways to mitigate the damage caused by opioid use among your workers
- Identify the right team members for the double play process
- Learn how to prepare the right settlement strategy
- Measure results of the double play process
[back to top] |
60 Medical Management Tips in 60 Minutes HM4
Fernando Branco, M.D., Medical Director, Rosomoff Comprehensive Pain Center, Miami
David Cooper, M.D., Director, The Knee Center, Wilkes-Barre, Pa.
Marjorie Eskay-Auerbach, M.D., J.D., President/Owner, SpineCare & Forensic Medicine, Tucson, Ariz.
Steven Feinberg, M.D., Chief Medical Officer, American Pain Solutions, Palo Alto, Calif.
Steven Moskowitz, M.D., Senior Medical Director, Paradigm Management Services, Walnut Creek, Calif.
Kathryn Mueller, M.D., Professor, Department of Emergency Medicine and School of Public Health,
University of Colorado Anschutz Medical Campus; Medical Director, Colorado Division of Workers’
Compensation, Denver
Moderator: Matthew B. Schiff, Partner, Schiff & Hulbert, Chicago
Thursday, Nov. 8 | 8:45 - 10 a.m.
These are challenging times. Addressing the needs of injured workers while holding down costs requires you to be focused and efficient. What are the best ways to work with physicians? Which treatments offer the best outcomes while being cost effective? How can you best address the opioid crisis? Our distinguished panel of physicians will share specific tips for overcoming medical barriers you are most likely facing.
Session takeaways:
- Strategies for best medical outcomes, such as focusing on defined functional treatment goals and measures
- Tips to prevent opioid abuse among injured workers
- Advice for effective ways to work with physicians
[back to top] |
The Economics of Medicare Set-Asides LR4
James J. Kennedy, III, Esq., Carlton Fields, Tampa, Fla.
Timothy K. Michels, Esq., Chief Operations Officer, IWIF, Towson, Md.
John P. Scott, CPCU, President, MGU Specialty Risk Services, LLC, Tampa, Fla.
Moderator: Jennifer C. Jordan, Esq., MEDVAL LLC, Columbia, Md.
Thursday, Nov. 8 | 8:45 - 10 a.m.
Many workers’ comp professionals accept the obligation to fund Medicare set-asides in the settlement of future medical obligations by simply following the method recommended by the Centers for Medicare and Medicaid Services. That’s a mistake, says this panel of renowned attorneys and insurance professionals. Understanding all the ramifications of the decisions that contribute to MSAs is imperative to achieve the most cost-effective outcomes. Come learn about the most significant unrecognized cost drivers and gain tools to make more successful Medicare secondary payer compliance decisions.
Session takeaways
- Understand the many options available in creating Medicare set-asides
- Dispel myths associated with MSAs
- Learn the unnecessary financial and legal costs of many MSA-related decisions
- Dissect hypothetical post-settlement scenarios to understand potential exposures
[back to top] |
The Role of Pharmacy Benefit Managers in the War on Opioids OS3
Michael Giusani, Vice President Clinical Services, RJ Health Systems, Rocky Hill, Conn.
Tim Pokorney, Director, Clinical, Express Scripts, Phoenix
Phil Walls, Clinical Director, myMatrixx, Tampa, Fla.
Moderator: Mark Walls, VP-Claims, Safety National, St. Louis
Thursday, Nov. 8 | 8:45 - 10 a.m.
Pharmacy benefit managers are the first line of defense in the war on opioids for most employers, insurers and TPAs. PBMs can have a significant impact on prescribing patterns, thereby controlling the overprescribing of Schedule II narcotics. This panel of PBMs will provide insight into the strategies they employ and show you how to work with your own PBMs for the best outcomes for injured workers, your employer and the bottom line.
Session takeaways
- Understand the myriad issues PBMs consider
- Learn actions PBMs should take to impact opioid use among injured workers
- Apply best practices for working with PBMs to address opioids use
[back to top]
Claim Cleanup: Review of Texas’ Closed Formulary and National
Implications OS4
Jim Andrews, SVP, Pharmacy Services, Cypress Care/Healthcare Solutions, Duluth, Ga.
Mark Pew, SVP, PRIUM, Duluth, Ga.
Thursday, Nov. 8 | 8:45 - 10 a.m.
America’s love affair with prescription drugs has had a stunning financial impact on the workers’ comp system. Virtually every jurisdiction has developed some sort of initiative to control pharmaceutical utilization and costs. Many are looking at the closed formulary in Texas as a model. As a workers’ comp stakeholder, you’ll gain an understanding of the successes – and challenges – in the Texas system, especially phase II: legacy claims. Plus, you’ll learn about the controls in place in other states and what Texas’ success could mean in terms of workers’ comp reforms elsewhere.
Session takeaways
- Learn the specifics of the Texas closed formulary – what it is and what it does
- Understand outcomes of an analysis of prescription drug utilization before and after the Texas system, including new and legacy claims
- Identify alternative medical treatments that are most effective
- Determine whether state legislative action is effective in controlling overutilization in workers’ comp
[back to top] |
MRIs and Knee Replacements: Two Easy Targets to Cut Medical Costs HM5
David Cooper, M.D., Director, The Knee Center, Wilkes-Barre, Pa.
James Pocius, Shareholder, Marshall, Dennehey, Warner, Coleman & Goggin, Philadelphia
Thursday, Nov. 8 | 10:45 a.m. - 12 p.m.
Why pay for a $1,200 MRI when a $200 ultrasound will do the same job and provide similar information about a knee or shoulder injury? It’s a question you’ll be able to answer after Dr. Cooper does a live demonstration of an ultrasound machine being used on a patient with a knee injury. Dr. Cooper will also explain the lack of scientific evidence for acute work-related trauma requiring knee replacements. Then, attorney Jim Pocius will arm you with the legal strategies needed to refute these claims.
Session takeaways
- Understand the benefits of and differences between ultrasound and MRI exams
- Learn the difference between arthritis aggravation and traumatic arthritis
- Understand why the majority of knee injuries heal without the need for knee replacements
- Gain legal strategies to defend against unnecessary knee replacement surgeries for workplace injuries
[back to top] |
Regional Conflicts: Drilling Down to Unique Issues
Thursday, Nov. 8 | 10:45 a.m. - 12 p.m.
The industry’s greatest challenges vary widely depending on the region of the country. While California struggles with liens, the Northeast deals with the shift from a manufacturing to a technology-based workforce – creating return-to-work nightmares. Many Midwestern states are focused on reforms to attract business; Western states are questioning the dominance of quasi-state insurers; and the Southeast battles opioid trafficking. In concurrent breakout sessions, thought leaders representing the employer, carrier and third-party administrator communities will discuss the most challenging issues (to be chosen closer to the conference) from each region and provide you with strategies to overcome them.
California
Moderator: Martin Brady, Executive Director, Schools Insurance Authority, Sacramento, Calif.
Carrier: Vern Steiner, SVP of Claims, Zenith, Los Angeles
Employer: Kevin Confetti, Risk Manager, Workers' Compensation, University of California, Oakland
TPA: Ralph Matthews, Vice President, Workers’ Compensation, Acclamation Insurance Management Services, Sacramento, Calif.
Midwest (Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska,
North Dakota, Oklahoma, South Dakota, Wisconsin)
Moderator: Pat Venditti, Director, BJC Healthcare, St Louis
Carrier: Stephan Cooper, President, United Heartland, New Berlin, Wisc.
Employer: Michael Chmielewski, Corporate Risk & Insurance Manager, Ace Hardware, Chicago
TPA: Ed Reasoner, Risk Management Department Manager, Thomas McGee L.C., Kansas City, Mo.
Northeast (Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey,
New York, Ohio, Pennsylvania, Rhode Island, Vermont)
Moderator:Maureen McCarthy, Senior Vice President, Liberty Mutual, Boston
Carrier: John Leonard, President and CEO, Maine Employers’ Mutual Insurance Company, Portland, Maine
Employer:Richard Graham, Corporate Director, Insurance & Risk Control, Crozer - Keystone Health System, Chester, Pa.
TPA:Steve Gidwitz, COO, NCA Comp, Buffalo, N.Y.
Southeast (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi,
North Carolina, South Carolina, Tennessee, Virginia, West Virginia)
Moderator: Michele Adams, Director, Claims Management, Risk Management Services, Walt Disney World Resort, Lake Buena Vista, Fla.
Carrier:Troy Prevot, Senior Vice President, LUBA Workers' Comp, Baton Rouge, La.
Employer: Lorraine Alexander, Risk Manager, Krispy Kreme Doughnut Corporation, Winston-Salem, N.C.
TPA:Gary Gilmour, Senior Vice President, Claims, Underwriters Safety & Claims, Louisville, Ky
West (Alaska, Arizona, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Texas, Utah, Washington, Wyoming)
Moderator: Denise Gillen-Algire, Practice Leader, Integrated Health and Productivity Management,
Risk Navigation Group, Albuquerque, N.M.
Carrier:Donald Smith, Jr., President & CEO, SCF Arizona, Phoenix
Employer: Tina L. Sanchez, Director of Workers Compensation, MGM Resorts International, Las Vegas
TPA:Tom Veale, President, Tristar Group, Long Beach, Calif.
[back to top] |
After the Deal: Adjusting to Consolidation of TPAs or Insurers CM5
Julia Sfurm, Corporate Risk Operations Manager, Elkay Manufacturing Co., Oak Brook, Ill.
Thursday, Nov. 8 | 1:15 - 2:30 p.m.
The consolidation of insurers and third-party administrators can be a nightmare for risk managers at client companies. How does the merger or acquisition affect your pending claims? What should you look for from the old or new company when managing the claims? How can you work through the claims process seamlessly? Ms. Sfurm, who went through this process when she was with a TPA and is going through it now as an employer, will share with you how to best evaluate the criteria that you’ll need and assess the possible pitfalls that may be caused by a merger or consolidation of your adjusting service.
Session takeaways
- Learn how to manage dual processes/teams during a transition
- Evaluate the claim handling process for past and future cohesiveness for the employer
- Assess the current workers’ comp program and determine what changes will be made and how they affect your program
- Know what questions to ask the adjusting company and communicate the changes to leadership within your organization
[back to top]
Inclusion Improves Outcomes: One Agency’s Success With High-Risk Claimants
CM6
Marcy B. Feuerstein, Consultant, Marrich Consulting Services, Queen Creek, Ariz.; former Officer of
Employee Benefits, Imperial Irrigation District, California
Thursday, Nov. 8 | 1:15 - 2:30 p.m.
Bringing problem claimants into the claims management process early and often can dramatically reduce lost workdays and improve the bottom line. A former risk manager for a California public agency will explain the program that ultimately helped her employer return about 95 percent of its injured workers to the company each year, earning her accolades from her peers throughout the country. Ms. Feuerstein will discuss how to include the high-risk claimant in case management and problem solving. She’ll also share trials and tribulations she confronted when developing this unique, successful program.
Session takeaways
- Learn an alternative way of managing stay-at-work/return-to-work meetings
- Explain how an accommodation can be a simple process
- Understand strategies to develop or enhance a disability management program
- Identify issues that impact the return of an injured employee and leverage them to expedite recoveries
[back to top] |
Attendant Care, Vans and Home Mods … Oh My! HM6
Sherri Hickey, Director of Medical Management, Safety National, St. Louis
Corey Staver, President & CEO, David Corey Company, Jacksonville, Fla.
Thursday, Nov. 8 | 1:15 - 2:30 p.m.
A company’s claims management process can be completely derailed by a single complex case. When durable medical equipment, home modifications or attendant care enter into the picture, many claims managers are at a loss as to how to proceed, since these issues do not frequently arise. But they happen on serious claims and adjusters need to be prepared. Two experts will discuss these high-cost issues, give you the questions you need to ask, and tell you what to look for to protect the bottom line.
Session takeaways
- Explain the underlying issues to consider for claims involving high-cost equipment
- Learn how to evaluate the various products and services available
- Be able to quickly identify the most appropriate, cost-effective equipment
[back to top] |
Causation: Medical, Versus Legal, Impairment, and Mental Trauma LR5
Stuart Colburn, Esq., Downs Stanford, PC, Austin, Texas
Robert G. Rassp, Esq., Law Office of Robert G. Rassp, Sherman Oaks, Calif.
Thomas A. Robinson, J.D., Author, Durham, N.C.
Moderator: Matthew B. Schiff, Partner, Schiff & Hulbert, Chicago, Ill.
Thursday, Nov. 8 | 1:15 - 2:30 p.m.
Medical causation and legal causation aren't the same. To properly manage claims, workers’ comp stakeholders need to distinguish between the two — and how they differ among jurisdictions — as well as understand the definitions of certain medical conditions and the standards of proof for each. This panel of workers’ comp attorneys will break down jurisdictionally differing definitions and offer tips to apply them to these potentially expensive claims.
Session takeaways
- Discuss repetitive motion and cumulative trauma injuries and their standards of proof
- Examine mental/psychiatric injuries and how states cover them
- Understand whether state legislative efforts to bar mental claim recovery might cost employers long term
[back to top] |
Opioid Treatment Guidelines: Getting Physicians On Board OS5
Kathryn Mueller, M.D., Professor, Department of Emergency Medicine and School of Public Health,
University of Colorado Anschutz Medical Campus; Medical Director, Colorado Division of Workers’
Compensation,Denver
Thursday, Nov. 8 | 1:15 - 2:30 p.m.
Why aren’t workers’ comp physicians doing a better job of getting patients off opioids? Studies show low compliance by physicians – even after guidelines have been put in place. Dr. Mueller says many are uncomfortable with drug testing, the use of contracts, and other measures designed to prevent opioid abuse. Find out what you need to know to encourage your physicians to follow better treatment standards while still maintaining care for their patients. As one of the pioneers in the fight against the opioid epidemic, Dr. Mueller will offer strategies to promote adherence to treatment guidelines.
Session takeaways
- Learn the medical components for any chronic pain opioid program
- Explain the actions that are difficult for physicians to follow
- Employ resources that can encourage physicians to follow treatment recommendations
- Understand system changes that promote adherence to guidelines
[back to top] |
Front and Center: Bloggers Speak Out on the State of Workers’ Compensation CM7
David DePaolo, J.D., Founder/President/CEO, WorkCompCentral.com, Camarillo, Calif.
Joseph Paduda, Principal, Health Strategy Associates; Author, ManagedCareMatters blog, Madison, Conn.
Peter Rousmaniere, Columnist, Risk & Insurance® Magazine, Consultant, Author, www.workingimmmigrants.com, Woodstock, Vt.
Rebecca Shafer, J.D., President, Amaxx Risk Solutions, Inc.; Author, ReduceYourWorkersComp.com blog,
Hartford, Conn.
Robert Wilson, President & CEO, WorkersCompensation.com, Sarasota, Fla.
Moderator: Mark Walls, VP-Claims, Safety National, St. Louis
Thursday, Nov. 8 | 3 - 4:15 p.m.
This group of popular industry bloggers have thousands of daily readers. Here’s a rare opportunity to see them together in one place weighing in on the latest industry trends that will be chosen in the weeks leading up to the conference. Guaranteed to be fast-paced, informative and entertaining!
Session takeaways
- Hear a variety of viewpoints on workers’ comp trends from industry veterans
- Learn some of the newest initiatives and their impacts on injured workers and employers
[back to top] |
Why and When Back Surgery Isn’t the Best Option HM7
Marjorie Eskay-Auerbach, M.D., J.D., President/Owner, SpineCare & Forensic Medicine, Tucson, Ariz.
Thursday, Nov. 8 | 3 - 4:15 p.m.
Money’s tight. Why spend it on surgeries known to produce bad outcomes? Yet that’s what many employers are doing when they pay for lumbar fusions for low back pain. Despite a significant increase in this treatment for injured workers in the last decade there is little evidence to support improvement in many cases. While certain conditions have predictable outcomes, others do not. Patient selection is key. Dr. Eskay-Auerbach shows you what to look for when surgery is recommended, how to identify patients most or least likely to benefit, and what alternative treatment options are available.
Session takeaways
- Recognize lumbar spine conditions that predictably will/won’t benefit from surgery
- Interpret the evidence-based medicine treatment guidelines related to surgical interventions
- Identify alternative low back pain treatments that may be more effective and less costly
[back to top]
Think Tank on Medical Management HM8
Facilitator: Gary Franklin, MD, Medical Director, Washington Department of Labor and Industries, Seattle
Thursday, Nov. 8 | 3 - 4:15 p.m.
Strategies to prevent disability and control rising medical costs in the workers’ comp system run the gamut — from treatment standards and guidelines, to early involvement of nurse case managers, and innovative models of health care delivery. You’ll have a chance to hash out issues and ideas with other seasoned professionals, in a collaborative environment. Attendees drive the topics, while the facilitator will help analyze critical problems, debunk some long-time ineffective approaches and develop solutions to help you move forward.
Session takeaways
- Brainstorm with your peers on challenges and solutions of medical management issues.
- Learn about successful and ineffective strategies other professionals are using.
[back to top] |
Employee or Independent Contractor? The Impact of Misclassification LR6
Stuart Colburn, Esq., Downs Stanford, PC, Austin, Texas
Robert G. Rassp, Esq., Law Office of Robert G. Rassp, Sherman Oaks, Calif.
Thomas A. Robinson, J.D., Author, Durham, N.C.
Moderator: Mark Noonan, Managing Principal, Casualty Practice, Integro Insurance Brokers, Boston
Thursday, Nov. 8 | 3 - 4:15 p.m.
The Government Accountability Office estimates that 15 percent of employers annually misclassify 3.4 million workers as independent contractors – and the Department of Labor, IRS and many states are cracking down. Misclassified workers are cheated out of workers’ comp and other entitlements, while the federal and state governments miss out on billions of dollars. Come hear our panel clear up this murky area of law.
Session takeaways
- Identify the four tests to determine whether a worker is an employee or an independent contractor
- Learn what different states are doing to combat the problem
- Provide tools for employers to protect themselves
[back to top] |
Mitigating Damages of Opioid Abuse: Employer Perspectives OS6
Sean McDaniel, Director, Claims Management, Veolla Environmental Services, Lombard, Ill.
Ron Thackery, VP, Safety, Risk Management, Emergency Medical Services Corporation, Greenwood Village,Colo.
Moderator: Teresa Bartlett, MD, Senior Vice President and Medical Director, Sedgwick Claims
Management Services, Inc., Troy, Mich.
Thursday, Nov. 8 | 3 - 4:15 p.m.
While we’re just beginning to understand the financial and medical effects of opioid use in the workers’ comp system, employers are starting to see unexpected impacts. Productivity and safety are suffering dramatically. You’ll hear the perspectives and the solutions of several employers who are finding ways to mitigate the damage caused by opioid use among their workers.
Session takeaways
- Discuss the specific impacts on the workplace from opioid use
- Learn strategies to reduce the costs and consequences associated with narcotics abuse
- Explain recent regulations and legislation aimed at controlling opioids at work
[back to top] |
|
The Experience Rating Worksheet: An Ever-Changing Story of Your Costs CM8
Kory Wells, Product Director, Broker Analytics, Zywave, Inc., Milwaukee
Friday, Nov. 9 | 9 - 10:15 a.m.
Do you think an experience modification value under 1.0 is good? Wonder why your ex-mod can increase, even when you’ve had no claims? Are you aware that in 2013 most states will adopt one of the most significant experience rating plan changes in 20 years? Risk managers and employers seeking to reduce their workers’ comp premiums will learn strategies to get a better handle on their experience modification value and find out how and where they can control their costs and improve productivity.
Session takeaways
- Examine the connection between your ex-mod and the premium you pay
- Explore how payroll and losses affect the ex-mod and the premium
- Discover the importance of the loss-free rating and how to calculate it
- Learn how quick calculations using values on your experience rating worksheet can point you toward business initiatives that deserve more attention
[back to top] |
Lessons From California: HCOs and MPNs as Medical Management Models HM9
Donald P. Balzano, President, Industrial Resolution Coalition; Chief Legal Counsel, Medex Healthcare, Inc., Long Beach, Calif.
Joel Sherman, Director of Safety and Workers’ Compensation, Grimmway Farms, Bakersfield, Calif.
Friday, Nov. 9 | 9 - 10:15 a.m.
Medical case management is a must for any company looking to reduce costs. Systems set up in California are helping some employers close claims quicker and return workers earlier – two keys to lowering workers’ comp costs. Health Care Organizations and Medical Provider Networks serve as a basis for employers in California and other jurisdictions seeking innovative new tools. Come learn what MPNs and HCOs are and how they can serve as cost-cutting models for employers anywhere.
Session takeaways
- Understand HCOs and MPNs and how they differ
- Determine whether an HCO and/or a MPN is a good option for your organization
- Learn strategies on how to use the underlying properties of these systems to expedite claim closures
[back to top] |
The New Mobile Workforce: Solutions to Unique Workers’ Comp Challenges LR7
Alan S. Pierce, Esq., Pierce, Pierce & Napolitano, Salem, Mass.
Roger A. Levy, Esq., Of Counsel, Laughlin, Falbo, Levy & Moresi, LLP, and Levy Mediations, San Francisco
Moderator: Stuart Colburn, Esq., Downs Stanford, PC, Austin, Texas
Friday, Nov. 9 | 9 - 10:15 a.m.
The mobile workforce raises all sorts of questions. Should an injury that occurs in a home office be covered by workers’ comp, when the employer has little or no control over the surroundings? Does the Going and Coming Rule apply to home-based employees traveling to see a customer? What about driving-related injuries that occur when an employee is texting in violation of state law — should that be covered?
Session takeaways
- Understand specific workers’ comp issues unique to remote workers
- Learn methods employers can use to maintain some control over home-based employees
- Apply the underlying concepts of workers’ comp to modern life
[back to top] |
The Insurer’s View: Developing a Narcotics Management Program OS7
Paul Kauffman, Director of Medical Programs, Accident Fund Insurance Company of America, Lansing, Mich.
Mark Pew, SVP, PRIUM, Duluth, Ga.
Jeffrey White, Director of Medical Management Strategy, Accident Fund Holdings, Lansing, Mich.
Friday, Nov. 9 | 9 - 10:15 a.m.
Between 55 and 85 percent of injured workers receive narcotics for chronic pain relief. The financial and human costs can be astronomical. Insurers and employers need strategies to deal with this epidemic. A narcotics management program need not be an elaborate scheme. It’s a matter of having some practical tools, understanding there is no cookie-cutter approach, and taking that first step. The speakers will present a narcotics management program developed through years of monitoring opioid use and will provide you with a mechanism to get these injured workers back to work sooner.
Session takeaways
- Understand results of a study on the national scope of long-term use of Schedule II narcotics
- Discuss the costs of opioids on workers’ comp claims
- Examine assessment of claimants and physicians using opioids
- Determine how to implement a multi-function solution-based process
[back to top] |
Considering Opt-Out: Lessons Learned From Two Employers CM9
Becky Robinson, Assistant VP, Hobby Lobby, Oklahoma City, Okla.
Rick Sumner, Director Insurance & Safety, Dollar General, 100 Mission Ridge, Goodlettsville, TN
Moderator: Jack Roberts, Managing Principal, New Street Group, Philadelphia
Friday, Nov. 9 | 10:45 a.m. - 12 p.m.
The opt-out system in the state of Texas may be catching on elsewhere. Pervasive discontent with the workers’ comp system is leading some stakeholders to consider whether other states should allow employers to exit their states’ systems as exemplified by the proposed legislation in Oklahoma. What are the benefits to the companies and the injured workers? What, if anything, are the drawbacks? You’ll hear from two employers who have opted to withdraw from the Texas workers’ comp system, plus see the unveiling of new research on the opinions of employers nationwide.
Session takeaways
- Understand the opt-out system as an alternative to state-based systems
- Learn the benefits and unintended consequences of opting out
- Understand the ramifications of opt-out systems on self-insured employers
[back to top] |
Cost-Effective Interventions for Psychosocial Risk Factors HM10
Darrell Bruga, DC, CEO, LifeTEAM Health, Los Gatos, Calif.
Marianne Cloeren, M.D., Medical Director, Managed Care Advisors, Bethesda, Md.
Friday, Nov. 9 | 10:45 a.m. - 12 p.m.
You’ve identified an “at-risk” claimant. Now what? You need practical strategies to specifically address the psychosocial factors that can prevent or reduce the severity of disability among the small percentage of injured workers on the road toward chronic disability. Dr. Bruga and Dr. Cloeren will show you a structured, systematic approach using evidence-based solutions, such as the Progressive Goal Attainment Program, to limit lost workdays and get your at-risk injured workers back on track.
Session takeaways
- Discuss how the current medical model of care may lead to work disability in some cases
- Identify practical strategies to incorporate cost-effective disability prevention approaches
- Explain research evidence for the effectiveness of specific interventions
[back to top] |
Opioids, Return-to-Work and the ADA OS8
Richard Pimentel, Senior Partner, Milt Wright & Associates, Granada Hills, Calif.
Friday, Nov. 9 | 10:45 a.m. - 12 p.m.
Employers face a conundrum in balancing the need for safety and productivity in the workplace with the legal rights of injured workers who are prescribed opioids. Refusing to allow such a worker to participate in a transitional employment program could be a clear cut violation of the Americans with Disabilities Act Amendments Act. Richard Pimentel, a return-to-work expert, will explain when it is — or is not appropriate to prohibit a worker on opioids from working, when and how employers may test for opioids, and whether employers can prevent workers from bringing opioids into the workplace.
Session takeaways
- Provide a guide on the amended ADA for legal and illegal opiate use.
- Learn what transitional employment assignments are compatible with opioids use.
- Understand how certain attitudes about opioid users can impact their recoveries.
[back to top] |
|
 
|
