Printed from BusinessInsurance.com

City criticizes, CorVel defends nurse case manager

Posted On: Feb. 12, 2015 12:00 AM CST

CORRECTION: An earlier version of this story included comments by an employee of Genex Services L.L.C., who declined to comment about the CorVel dispute and whose statements were about nurse case management in general.

A dispute between Fort Worth, Texas, city officials and CorVel Corp. over alleged “inflammatory questions” asked of a wounded police officer could lead nurse case managers to be more cautious when dealing with such cases.

Fort Worth Mayor Betsy Price called for an audit of CorVel on Feb. 5, one week after a nurse case manager for the Irvine, California-based managed health care services and medical cost containment provider arrived at Texas Health Harris Methodist Hospital to meet police Sgt. Shane Drake, who was shot in the stomach while responding to a panic alarm at a home, according to media reports.

The unidentified nurse asked “inflammatory questions” of hospital workers, Sgt. Drake's family and co-workers, and co-workers subsequently filed complaints that led to the audit, according to the reports.

The city and the Fort Worth Police Officers Association declined to disclose what questions were asked.

CorVel could not be reached for comment, but said in a statement that “the nurse acted professionally and responsibly” and called the incident “an unfortunate misunderstanding.”

CorVel's contract with the city of Fort Worth states that it must “immediately assign” a nurse case manager to an injured worker when there is a catastrophic or severe occupational injury, the company said in the statement.

While the information nurse case managers listen for during conversations with injured workers is much the same, their approaches will differ depending on the severity of the claim, experts say.

In the case of a catastrophic injury such as Mr. Drake's, where a nurse is asked to be at the hospital, the first thing the nurse should do is tell the injured worker and/or family members that he or she is there as a patient advocate and liaison for them, the medical providers and the employer, said Suzie Burdette, Birmingham, Alabama-based vice president of managed care and case management for WellComp Managed Care Services, a subsidiary of York Risk Services Group Inc.

Kathryn L. Bell, field case management area manager for Broadspire Services Inc. in Sunrise, Florida, did not comment on the CorVel incident. In an email discussing nurse case management strategies, she said, “Taking a holistic approach and looking at all parts of an injured worker's lifestyle in addition to the medical issues leads to improved medical outcomes, which results in a quicker return to work.”

Fort Worth officials said the review of the 2-year-old contract with CorVel would take about a month.