The recent news concerning the Spitzer investigations, Broward County’s Work Comp troubles, the Arthur Gallagher payment inquiries and the adverse publicity surrounding same has caused some industry players to delay decisions regarding new initiatives. TPAs particularly have pulled back from some previous “done deals” while they re-examine their business practices, commission arrangements, and relationships with managed care firms.
I am attending the Florida Workers’ Comp Institute, and after one evening’s discussions with several vendors and TPAs the impact is obvious and considerable. Both are lamenting the delays imposed by TPA senior management.
This is a good thing. For far too long, the relationships between some TPAs and insurance companies and their servicing entities has been somewhat cloudy, with rumors of commissions, kickbacks, and other behind-the-scenes payment arrangements periodically surfacing. Now that the Broward audit and Spitzer inquiries (which include subpoenas of managed care firm Concentra and several insurers and TPAs) have shed some light on these practices, risk managers, brokers, and CFOs are paying much closer attention to these relationships.
Part of this increased attention may well be due to the potential for OFAC and Sarbanes – Oxley complications. I am certainly no expert, but the provisions of the “Sarbox” law that require CEOs to sign off on financial statements coupled with the OFAC reporting requirements (who receives funds from the corporation) appear to be playing a significant role.
What does this mean for you?
If you have always competed fairly and ethically, good things. If you have played fast and loose, troubles ahead.
Hallelujah.
Aug
22
I wonder where Mr. Paduda gets his FL information since he resides in CT. Does he have an ownership interest in a TPA located near Tampa that wants to become a major player or perhaps an ownership interest in a physical therapy vendor also situated near Tampa.
Mr. Beceneu – you would be surprised how easy it is to get information about any number of topics via the internet. Amazing invention. There is also a new concept – travel. You meet interesting people, and find out interesting things. It is amazingly easy.
As to your comments re an ownership in a PT clinic or TPA, where you came up with that is a mystery – if you are implying that I have information because I own a business in FL, what difference would that make?
If you are implying that I have an ax to grind, I do. Unethical behavior is wrong, damages our industry, and those who would attempt to deflect attention away from these core issues via innuendo are also damaging the business.
What is your agenda?