Industrial Strength Fine for Occupational Healthcare Provider By Robert Warne - April 15, 2003
The Department of Insurance (DOI) caught the state’s largest provider of occupational healthcare services playing by its own rule book when it came to producing a doctor’s first report of injury.
U.S. Healthworks and Alternative Solutions, Inc. was accused of crossing the line of Dr./Employer relations in many of its 57 California locations by allowing employers to make the call if a report of injury should be filed or not.
Whether this was a case of liberal legal interpretation on the medical provider’s part or not, investigators found enough evidence to force U.S. Healthworks to settle, April 15.
The practice of withholding information undermines the accuracy of setting insurance rates based on the frequency of injuries or illnesses.
By law, a physician is required to file a doctor’s first report of injury with the employer’s claims administrator after an employee is first treated. The administrator is then required to forward a copy of the report to the Department of Industrial Relations.
In a deal cut with the DOI, U.S. Healthworks escaped having to admit liability in exchange for an agreement to pay $900,000 in civil penalties, investigative costs and a fraud assessment.
Adjuster / Examiner Claims Examiner Santa Ana Unified School District Santa Ana, CA
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