There were questions about peer review, Dr. Stotz reviewed areas of concern for reviews, including identical treatment patterns for family members in PI cases, high tech testing, routine outside referrals, and illegible notes. It was suggested that insurance adjusters improve the lines of communications with the DC's to reduce areas of concern. There was discussion about long periods of care without significant changes. MMI requires supportive care that doesn't end. Exacerbation is defined by increased symptoms resulting from everyday activities.
New injury requires new incident or trauma.
Mark Stevens has info from courts defining exacerbation Vs new injuries. Insurance representatives were told that peer review members could testify for peer review, but will only testify as to the peer review process. Dr Greg Lowenberg discussed with the board his frustration of his recent diluge of 7 reviews over the last 10 days, asking the board for recommendations and insight as to why these reviews are being implimented. Dr. Stotz also reviewed the request by State Farm to do more work comp. Dr. Stevens will be giving similar information to 150 insurance adjusters in Sioux Falls next weekend.