april 30, 2008 quarterly report january, … la quinta benton 0.5 hospitality workplace violence...

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



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


Clay

GreeneLawrence

Izard Sharp


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


Sevier

HowardPike


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



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



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


Clay

GreeneLawrence


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


Sevier

HowardPike


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



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


Clay

GreeneLawrence

Izard Sharp


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


Sevier

HowardPike


Lafayette

Clark

Nevada

Columbia

Grant

Dallas

Ouachita

Calhoun

Union

Jefferson

Cleveland Lincoln

Bradley

Drew

Ashley Chicot

Desha

ArkansasHot Spring

Presentations and Speaking Engagements



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



BooneBenton Carroll

Marion


Clay

GreeneLawrence

Izard Sharp


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


Sevier

HowardPike


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




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




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



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


april 30, 2008 quarterly report january, … la quinta benton 0.5 hospitality workplace violence...

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