It’s here and it’s 750 pages long.  It was originally published in February, 2008.  And on November 17th, the Department of Labor finally published its revised regulations to guide employers as we navigate FMLA.

Employers had identified many areas that required clarification  since the FMLA was enacted. And the new regulations do address many of them.  For instance, most of us see a potential of abuse of intermittent leave and  we also find gray areas that prevent asking medical questions regarding FMLA that are allowed under the ADA.

But, and it’s a big but, according to Frank Alvarez of Jackson Lewis, ” Many employers do not have the resources to master complex FMLA rules.  Most are cutting staff and slashing training budgets.  At the same time, they can’t afford to ignore this issue.  FMLA is a major compliance obligation, and in the midst of today’s economic uncertainty, attendance and productivity can be keys to a company’s survival.”

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Recently, we were asked ” Just what are the hidden costs of managing medical surveillance programs that you sometimes talk about?”  That may sound like a simple question but it really leads to a series of much more difficult questions.

 When was the last time that one of your new hires had his start date delayed because his medical clearance had not been received?

Did the delayed start cost you billable hours?

Did the delayed start cost you additional overtime or additional payments for contract personnel?

When was the last time one of your field personnel had to return to a clinic a second time or even a third time because some portion of the annual medical requirement had been omitted?

How many errors are there on the bills you review?

The cost of an asbestos exam isn’t simply what the clinic charges you for that exam.  Did they do the correct exam, with only the necessary components, in a single visit with minimal waiting time and report it  and bill it accurately in a timely fashion?

The DOT announced new collection rules were to become effective August 26th and then, in a surprising move, delayed the implementation of a large portion of the new rules until November 1st.  The new rules relate to observed collections  on return to work and follow up tests.

In that past, observed collections were only required in a handful of circumstances and realistically, are relatively rare.  Under the new rules, they will be much more common - presenting new challenges for medical facilities, patient service centers and  collection sites.  Collection sites were very much the focal point of the May 2008 GAO report where drivers reported that cheating on collections was more common than previously thought.

The implementation delay does add a level of confusion to an already burdened nationwide collection system.  Since the postponementwas to extend the comment period, it is likely there will be additional delay beyond the new November date if comments were to raise issues that must be addressed prior to roll out.

Some critics call the new rules draconian - requiring those drivers who are having return to duty or follow up screens to raise shirts above waists and lower underwear.  We’ve seen many kinds of home-made or internet purchased devices; designed to sneak a urine specimen into the bathroom.  But not terribly often and usually among non-DOT regulated donors. 

So, here we sit, having prepared collection sites nationally for new procedures, and then advising them that most are on hold.  Stay tuned….

 For additional information:

 http://www.jacksonlewis.com/legalupdates/article.cfm?aid=1467

 http://www.littler.com/PressPublications/Lists/ASAPs/DispAsaps.aspx?id=1278

This week, articles on medical tourism have appeared in most major newspapers and on-line news outlets.  And for the first time, employers are asking Corporate Wellness what we think?  Good question - Our answer:  the jury is still out… 

What is medical tourism?  Simply put - it refers to the relatively new practice of patients going abroad to purchase medical services .  It is gaining in popularity and in some sets, all the rage-  combining high quality medical care at reduced prices and a vacation.  Almost sounds too good to be true!

According to the British Medical Journal, Lancet, about 40% of medical tourists are seeking the very best care - the newest technologist, the most recently developed procedure while approximately 32% are seeking treatment that is more affordable.

There are wonderful stories about patients going abroad for everything from dental work to gastric banding.  The savings on certain procedures, like dental implants or tummy tucks, is significant.  However, it seems that at Corporate Wellness, we’ve managed a disproportionate number of disability cases where employees who had gastric bypass in particular didn’t fare well on their return to the US. Read the rest of this entry »

Around this time of year every year, we start to get calls from our corporate clients asking us what to expect this flu shot season.  And nearly every year, we have different answers from the previous year.

The good news….

There are more manufacturers and much more vaccine being produced this year than in previous years.  Upwards of 150 million doses should be available between August 1st and November 30th. The price of flu vaccine is up too, although much less than in other flu seasons.  We’ve seen increases averaging 10% in past years. This year, prices are up only slightly (although nursing and shipping costs are up). More… Advances in flu vaccine manufacturing, moving away from egg-based manufacturing to newer cell technologies are moving forward.  Flu vaccine is still generally reliant upon the availability of sterile eggs (used as the medium in which the strains are grown).  The newer cell technologies don’t require eggs, are much more targeted in strain selection and eliminate the allergy concerns for those allergic to eggs. Read the rest of this entry »

This week, SHRM, the Society for Human Resource Management, released the findings from it January 2008 poll of members regarding employee flu shots.  And overall, their news was good.   They found that: 

• 59 percent of employers offered free flu shots to employees - up 5% from last year
• 52 percent of employers made hand sanitizers, tissues and other items that help prevent the spread of flu available to employees - up from only 2% the previous year. 
• Most importantly, a full one third of employers sent sick employee home vs. only 20% in 2007.
  

That’s progress!

 The CDC – AMA National Flu Summit meets the second week in May in Atlanta.  The medical professionals attending are very concerned that this past year’s flu season, with a less effective vaccine than past years, will discourage employers from offering flu shots this year and employees from taking flu shots. 

As we had hoped, the Ninth Circuit Court of Appeals reversed an earlier decision that held UPS liable for making sure its drivers could hear before driving. Seems a bit silly that they had to go to all the way to the Appeals level for that ruling, doesn’t it?

The earlier ruling by a three judge panel, also in the Ninth Circuit, told employers that they couldn’t screen prospective employees to ensure they could safely perform the essential functions of their jobs if they were screening for conditions that might be considered disabilities.So, according to the original ruling - knowing that employees can see or hear to identify safety hazards around them wasn’t considered as important as making sure they weren’t discriminated against if they couldn’t see or hear.

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In an aggressive move, Walgreens bought not just one but both national providers of on- site employee health clinics. These two acquisitions will make up the cornerstones of Walgreen’s new Health and Wellness Division. This is an interesting move that HR and Benefits Managers and occupational health professionals will be closely watching.

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You’ve already heard that this is a nasty flu season. What makes this flu season so nasty - particularly for employers? Is there anything you can do about it now? Several employers a day are calling to talk about:

• widespread employee absences
• a cacophony of sneezing and coughing
• delayed projects and lower productivity

 Why?

We’ve reached the peak of flu season and it is a nasty one. This flu season is as nasty as it is in part because it arrived slightly later than usual which always makes it worse. Then, we found that there is a poor match between the vaccine and the main strain of flu that is circulating.  Is there anything an employer can do at this point? Yes! It may be too late for flu shots to be cost effective but: Read the rest of this entry »

Welcome to the Corporate Wellness Blog.  I’ll be blogging about employee health and wellness issues; our experiences and those of our clients (don’t’ worry – we won’t be naming names). Shortly, we’ll be celebrating Corporate Wellness, Inc. twentieth year.  An observation we made during the first week holds true a thousand weeks later – no two days are alike; no two employee health situations are identical and no client crises are ever exactly the same.  The body of knowledge and experience we’ve built over the years provides us with a unique perspective on healthcare, employee benefits, drug screening, DOT Medical Certificates and other employee health and employment issues that we’ll be sharing here.  We have no doubt that over drinks with your co-workers or dinner with your family, you’ll be sharing one of the stories you read here.