National – Workers’ Compensation Research Institute (WCRI) released its Medical Price Index for Workers’ Compensation. The report compares prices paid for medical professional services across 36 states from 2008 to 2024. The 36 states include: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. The report focuses on services commonly billed by physicians, physical therapists, and chiropractors.
CLARA Analytics unveiled a study showing that AI can identify insurance fraud just two weeks after a claim is filed. Analyzing claims from 2020 to 2024, the study found that 9% were flagged for investigation. The AI model's predictions matched actual referrals faster, uncovering connections missed by traditional methods. According to the study, Michigan and Arizona had the highest percentages of potential fraud indicators.
Colorado – HB 25-1222 passed both chambers of the Colorado General Assembly and was sent to Governor Jared Polis for consideration. As a reminder, HB 25-1222 aims to preserve healthcare access provided by rural independent pharmacies in Colorado. The bill ensures fair reimbursement rates from pharmacy benefit managers (PBMs), allows the use of private couriers for prescription deliveries, and defines “flex pharmacies” to operate as telepharmacies under certain conditions.
Florida – The Workers’ Compensation Research Institute (WCRI) published the 2025 edition of Florida’s CompScope Benchmark report. This report evaluates the performance of Florida's workers' compensation system with 17 other states, focusing on various metrics. These metrics include income benefits, overall medical payments, benefit utilization, duration of temporary disability, frequency and payments of permanent partial disability (PPD)/lump-sum claims, benefit delivery expenses, litigiousness, and timeliness of payments. The report emphasizes wage growth significantly influenced Florida's workers' compensation costs per claim in 2022 and 2023.
Minnesota – HF 3228 passed the Senate and was presented to the Governor this week. As a reminder, HF 3228 aims to amend Minnesota's workers' compensation statutes. Specifically, it updates the definition of “employee” to include voluntary, uncompensated workers, students in medical programs, and military members. It also changes the daily wage calculation for compensation to be based on the usual wage for similar services and requires employers to provide comprehensive medical treatment for injured employees.
Nebraska – LR 124 was referred to the Banking, Commerce and Insurance Committee. The bill would create an interim study to examine the role of pharmacy benefit managers and their impact on prescription drug prices. Specifically, the bill aims to investigate issues around transparency, reimbursement models, formulary management practices, and the impact on independent pharmacies and patient access to affordable medications.
Texas – SB 493 passed the House this week. As a reminder, SB 493 is designed to safeguard the ability of pharmacists and pharmacies to communicate openly about prescription drug benefits. The bill would allow pharmacists and pharmacies to discuss cost-saving options and provide patients with information on drug pricing and benefits without fear of retaliation or penalties.
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