Email shows PBM knowingly overcharged state, Ohio AG says
The Office of the Ohio Attorney General says it may have uncovered evidence a pharmacy benefit manager knowingly overcharged the Ohio Bureau of Workers’ Compensation by failing to charge the lowest of four potential prices for generic drugs from 2009 to 2018. According a lawsuit, OptumRx overcharged the agency on 57 percent of 2.3 million prescription claims between January 2014 and September 2018. Columbus Dispatch
Maine court rules salmon farm employee covered by workers’ comp
An employee of an aquaculture salmon operation who was injured while tending fish raised in offshore pens is covered under state law, but not under the federal law that defines some of the rights for mariners, Maine’s highest court has ruled. The insurer had argued the Workers’ Compensation Board lacked jurisdiction because the employee should be considered to be a “seaman” under federal admiralty law. Albany Times Union [may require registration]
Pennsylvania to transfer money from workers’ comp fund to aid businesses
Pennsylvania Governor Tom Wolf says he will transfer $145 million in funds from the Workers’ Compensation Security Fund to help businesses through the pandemic. The proposal would require a vote from the Republican-majority legislature to appropriate the money. KDKA (Pittsburgh)
Alabama paramedic recovering from COVID-19 denied workers’ comp
An Alabama paramedic who for months transported and treated COVID-19 patients while wearing personal protective equipment and following safety protocols has had her workers’ compensation claim denied on grounds that it’s not possible to prove she didn’t get COVID somewhere else, including while she was in the hospital. Alabama law does not cover COVID-19 as a work-related illness, even for frontline workers. WBRC [with video]
Juvenile detention officer charged with illegally collecting workers’ comp
A 35-year-old East Haven, Connecticut man has been charged with illegally collecting workers’ compensation while being employed as a juvenile detention officer. Authorities say that, while receiving workers’ comp, he failed to disclose coaching a youth football team and that he was observed engaging in physical activities that could not be performed under his supposed status. WFSB (Rocky Hill, Conn.)
Virginia first responders in workers’ comp dispute with county
A union representing Fairfax County, Virginia firemen says its members are entitled to workers’ compensation if they have been exposed to COVID-19 while on the job, but their claims are being denied and they are depleting their sick leave in order to comply with mandatory quarantine requirements when they’re exposed to coronavirus. The union argues the county should assume they contracted COVID while on the job. WUSA (Washington, D.C.)
South Carolina bill that would cover first responders revived
A bill in South Carolina that has garnered bipartisan support would establish a presumption healthcare employees and first responders who contract COVID-19 did so at work and, thus, would be eligible for workers’ compensation. An earlier version of the bill did not make it to a vote this legislative session. WMBF (Myrtle Beach, S.C.)
Acrobats injured in 2014 fall reach settlement
Eight acrobats injured in a fall during a 2014 performance in Providence, Rhode Island have reached a $52.5-million settlement with the Rhode Island Convention Center Authority and the company that manages the center. The acrobats suffered broken bones and internal injuries. Two had severe spinal injuries and remained unable to walk a year later. Providence Journal