About
Carlos Luna brings nearly two decades of expertise at the intersection of workers’…
Articles by Carlos
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Government Dignitaries Give Praise to Ag Community Amid Height of the Pandemic
Government Dignitaries Give Praise to Ag Community Amid Height of the Pandemic
By Carlos Luna
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ACOEM Publishes COVID-19 EBM Practice Guideline
ACOEM Publishes COVID-19 EBM Practice Guideline
By Carlos Luna
Activity
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Who is ready???? KNOW YOUR WORTH! We Do!
Who is ready???? KNOW YOUR WORTH! We Do!
Liked by Carlos Luna
Experience
Education
Publications
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Government Dignitaries Give Praise to Ag Community Amid Height of the Pandemic
WorkCompCentral
The agriculture industry recently came together for AgSafe's Innovation Virtual Conference. During the conference's two-day track on state and federal regulatory compliance, dignitaries from various government agencies echoed one another in vocalizing high praise for America’s agriculture community amid the height of the COVID-19 pandemic. Here is a recap of the event's highlights.
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Coping With COVID-19
WorkCompCentral
Throughout my career, I’ve learned to lean on a couple of very rudimentary, yet highly effective, elements to help keep me focused and composed in times of high anxiety and uncertainty. I hope this column edifies and helps you cope with the ongoing COVID-19 crisis and its effects on many aspects of our society.
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Let the People Choose
WorkCompCentral
On September 24, the Comp Laude® Awards and Gala featured eight industry leaders as part of the People’s Choice Awards, which is quickly becoming the signature event of the conference. This group of individuals represented the legal, medical management, client services, and marketing business verticals in workers’ comp.
Other authorsSee publication -
Employers, Work Comp Stakeholders Sound Off
WorkCompCentral
The nation’s largest workers’ compensation community came together recently in Dana Point, California to attend one of the country’s more prominent trade conferences. To kick off the event, a panel of work comp subject matter experts, representing system stakeholders and employers, was assembled to address issues ranging from California’s chief public official’s appetite to tamper with seemingly sound system reforms to automation and technology’s role in workers’ compensation.
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Turning the Clock Back on State's Workers' Compensation System
WorkCompCentral
California's Assembly Insurance Committee is having a public hearing on AB 1107 on Wednesday April 24th. Is the bill a step in the right direction in promoting prompt, adequate medical treatment for injured workers in the State of California? Fortunately, we have a material amount of data to help inform the answer to this question.
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The King Case: Imperceptible Implications for UROs
WorkCompCentral
Irrespective of overwhelmingly positive data published on appropriate UR decisions, the UR process becomes a target of criticism. Largely driven by a lack of understanding, a push to unravel this layer of protection for injured workers persists. The over-utilization of unnecessary medical care is not a benefit, it is a risk. These are my thoughts on how the King case may motivate this movement come next year’s legislative session.
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The Narrative in Workers’ Compensation is Changing
WorkCompCentral
Tragedy has a way of spurring unexpected outcomes bringing people from all walks of life and disciplines. These are my observations on important paradigm shifts happening throughout workers’ compensation partly due to the global tragedy that is the opioid epidemic.
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Complacency or Complexity: UROs Crawl to Accreditation
WorkCompCentral
Another important July 1st deadline has come and gone for the California workers’ compensation community. As of mid-June, nearly half of California’s Utilization Review Organizations had yet to complete the accreditation process required by newly modified Labor Code section 4610(g)(4). Is the crawl to compliance due to a complacent system culture or a costly and complex accreditation process?
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The Crux of the Opioid Epidemic
WorkCompCentral
The crux of the opioid crisis is in unchecked, inappropriate prescribing habits. Absent of comprehensive medically responsible prescribing standards, today’s opioid issue has the potential to evolve into another prescription drug crisis. Are narrow legislative bills enough to keep injured workers safe and encourage a paradigm shift among prescribers?
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It's About Time Feds Focus on States' Success in War on Opioids
WorkCompCentral
The U.S. House of Representatives has held numerous information-gathering meetings. The divide that exists between state and federal government has never been more clear as the feds turn their focus on the success that state workers’ compensation systems are having in the war on opioid abuse. But, are all aspects of the crisis being considered?
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Beyond Pennsylvania Politics
WorkCompCentral
Pennsylvania, who is hosting one of the fiercest battles in the war on opioids, will not adopt a nationally recognized evidence-based medicine drug formulary. Is this the outcome of Pennsylvania politics, the right move to preserve the doctor to patient relationship?
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Workers' Comp Needs Quality Measures for Clinical Practice Guidelines
WorkCompCentral
The importance of the National Guideline Clearinghouse™ (NGC) cannot be validated by someone continuing its work. Its importance was established in 2008 by U.S. Congress. Without appropriate oversight in the development of this content, anything might be called "quality" imperiling the well-being of injured workers. Here is my take on why "WorkComp Needs Quality Measures for Clinical Practice Guidelines".
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Opioid Epidemic Deserves More Than a Closed Formulary
WorkCompCentral
The national Workers' Compensation community is at risk of losing the plot of the opioid epidemic. The aggressive assault against opioid abuse may be relying too much on over-simplified medicine. It is essential to expand the conversation to emphasize the importance of the overall care of a patient and improve the tracking of health outcomes. The discussion can no longer be just about drugs and potential savings.
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Thursday Thought Leader: Carlos Luna
LegalNet, Inc.
The workers’ compensation industry gets a bad rap for surviving off of people’s accidents and injuries, but there’s something that you have to know. First things first, someone has to do it. Second of all, many of the leaders in this industry only possess good intentions and are fighting for a bigger, more positive cause.
A good example of the latter? Carlos Luna.
As the Director of Government Affairs at Reed Group and Medical Issues Committee Member of IAIABC, he is constantly…The workers’ compensation industry gets a bad rap for surviving off of people’s accidents and injuries, but there’s something that you have to know. First things first, someone has to do it. Second of all, many of the leaders in this industry only possess good intentions and are fighting for a bigger, more positive cause.
A good example of the latter? Carlos Luna.
As the Director of Government Affairs at Reed Group and Medical Issues Committee Member of IAIABC, he is constantly on the hunt for learning and sharing newfound knowledge in this industry. He’s been personally affected by a close family member who had to go through a workers’ compensation accident, so his fight for what’s right is all too real.Other authorsSee publication -
Content Out of Context
WorkCompCentral
Regulating the use of evidence-based medicine standards by state jurisdictions tends to polarize workers’ compensation stakeholders – sometimes for good reason. However, an important attribute that is evident in a well-developed medically responsible EBM standard can be easily overlooked: EBM guidance may not always be unequivocal.
The data is clear. The impact that EBM has on improved health outcomes in workers’ compensation is overwhelmingly positive. Continue reading to get my take…Regulating the use of evidence-based medicine standards by state jurisdictions tends to polarize workers’ compensation stakeholders – sometimes for good reason. However, an important attribute that is evident in a well-developed medically responsible EBM standard can be easily overlooked: EBM guidance may not always be unequivocal.
The data is clear. The impact that EBM has on improved health outcomes in workers’ compensation is overwhelmingly positive. Continue reading to get my take on why it is counter-productive to use the content out of context. -
Patient Engagement in Workers' Compensation
WCC'S WORK COMP WORLD
The call to increase patient engagement to inform the development of standards and policies is gaining traction. Efforts to consistently collect and incorporate patient perspectives into the scientific process is becoming a priority for many. This is welcome news to all patients and patient advocates!
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A Case for National Standards in State Workers' Compensation
WorkCompCentral
In the Workers’ Compensation system, variances from one state to another seem endless. The source of variability is often the disparity in resources available to state regulators across jurisdictions. Is it reasonable to suggest that the varying availability of resources from state-to-state presents limitations for regulators in their pursuit to appropriately research prospective public policy that will improve system outcomes? Would establishing national standards help level the playing field…
In the Workers’ Compensation system, variances from one state to another seem endless. The source of variability is often the disparity in resources available to state regulators across jurisdictions. Is it reasonable to suggest that the varying availability of resources from state-to-state presents limitations for regulators in their pursuit to appropriately research prospective public policy that will improve system outcomes? Would establishing national standards help level the playing field for states having to make due with less available resources?
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Removing Friction From California's Workers' Compensation System
WorkCompCentral
The addition of the California ACOEM-based drug formulary, in concert with the impending updates to various treatment guidelines (following the new expedited process set forth in SB 1160), in MTUS will improve the system by increasing the use of evidence-based care administered to patients, thereby reducing the inappropriate prescription of dangerous drugs and inappropriate medical treatment, and reducing system friction by providing a common standard to base medical decisions for injured…
The addition of the California ACOEM-based drug formulary, in concert with the impending updates to various treatment guidelines (following the new expedited process set forth in SB 1160), in MTUS will improve the system by increasing the use of evidence-based care administered to patients, thereby reducing the inappropriate prescription of dangerous drugs and inappropriate medical treatment, and reducing system friction by providing a common standard to base medical decisions for injured workers at every step in the care and claim continuum.
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Value-based care gains traction
Insurance Business Magazine
The US market loses serious dollars in lost productivity due to health-related conditions – more than $225 billion, according to a report by Carlos Luna, director of government affairs for MDGuidelines. In response, Luna says employers are looking for alternatives that would deliver the “best medical results at the best prices” for workers on the mend.
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Guest Post: Carlos Luna on Why Details Matter for Louisiana in the Formulary Debate
Louisiana Comp Blog
Be sure and read my latest Guest Post published in the Louisiana Comp Blog where I explain how comparing the Texas Worker's Compensation system to Louisiana’s system is like comparing apples to oranges. The expectations for similar outcomes using the same Drug Formulary is a stretch at best. If Representative Kirk Talbot's HB 592 passes, the Louisiana formulary experiment will take place at the expense of injured workers. What are your thoughts on how Louisiana can improve the quality of care…
Be sure and read my latest Guest Post published in the Louisiana Comp Blog where I explain how comparing the Texas Worker's Compensation system to Louisiana’s system is like comparing apples to oranges. The expectations for similar outcomes using the same Drug Formulary is a stretch at best. If Representative Kirk Talbot's HB 592 passes, the Louisiana formulary experiment will take place at the expense of injured workers. What are your thoughts on how Louisiana can improve the quality of care provided to injured workers while addressing the opioid crisis?
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Guest Post: Carlos Luna on the National Guideline Clearinghouse and its Relevance
Louisiana Comp Blog
In the following guest post, Carlos Luna, Director of Government Affairs for Reed Group’s MDGuidelines, explores the National Guideline Clearinghouse and whether or not it performs its function – assessing the quality of medical guidelines and improving transparency in the guideline industry.
As the Louisiana Legislature is soon to begin its Regular Session on April 10th and workers’ comp officials anticipate a bill to incorporate the ODG formulary in Louisiana’s system, read on to get…In the following guest post, Carlos Luna, Director of Government Affairs for Reed Group’s MDGuidelines, explores the National Guideline Clearinghouse and whether or not it performs its function – assessing the quality of medical guidelines and improving transparency in the guideline industry.
As the Louisiana Legislature is soon to begin its Regular Session on April 10th and workers’ comp officials anticipate a bill to incorporate the ODG formulary in Louisiana’s system, read on to get Luna’s take on how the National Guideline Clearinghouse could benefit stakeholders across the board. -
It’s About Time – Value-Based Care Comes to Workers’ Compensation
WorkCompWire
With the total annual cost of lost productivity attributable to health-related conditions exceeding $225 billion in the United States, employers are looking for ways to get the best medical results at the best prices for injured workers. More than 40 percent of employers are considering implementing value-based plan designs or high-performing networks in the coming year. Worker’s compensation providers who don’t adopt a value-based care model may find themselves left out of narrow networks in…
With the total annual cost of lost productivity attributable to health-related conditions exceeding $225 billion in the United States, employers are looking for ways to get the best medical results at the best prices for injured workers. More than 40 percent of employers are considering implementing value-based plan designs or high-performing networks in the coming year. Worker’s compensation providers who don’t adopt a value-based care model may find themselves left out of narrow networks in the not too distant future.
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The Problem With Treatment Guidelines and Drug Formularies
WorkCompCentral (Subscription Required)
As discussions about adopting #evidencebasedmedicine guidelines and #drugformularies become more common place throughout the country, it is imperative that the workers' compensation industry have a good working knowledge of traits present in #trustworthy #EBM - not all guidelines are created equal.
Misconceptions exist about the content, and the tools it powers, and who it benefits most. EBM is not primarily for cost containment, it is not a license to deny needed care to patients, and…As discussions about adopting #evidencebasedmedicine guidelines and #drugformularies become more common place throughout the country, it is imperative that the workers' compensation industry have a good working knowledge of traits present in #trustworthy #EBM - not all guidelines are created equal.
Misconceptions exist about the content, and the tools it powers, and who it benefits most. EBM is not primarily for cost containment, it is not a license to deny needed care to patients, and it is not one-size-fits all medicine. Let me know your thoughts on how EBM can be better leveraged to improve the quality of care to #injuredworkers. -
Rethinking Return-To-Work
WorkCompCentral (Subscription Required)
Keeping workers employed while they’re recovering from a work-related injury or illness is just one approach to rethinking the role of return-to-work guidelines, a hot topic of discussion several recent conferences, and the main focal point of the webinar presentation “Changing Perceptions About Return to Work Confirmation,” hosted by the International Association of Industrial Accident Boards and Commissions in conjunction with the National Institute for Occupational Safety and Health’s Center…
Keeping workers employed while they’re recovering from a work-related injury or illness is just one approach to rethinking the role of return-to-work guidelines, a hot topic of discussion several recent conferences, and the main focal point of the webinar presentation “Changing Perceptions About Return to Work Confirmation,” hosted by the International Association of Industrial Accident Boards and Commissions in conjunction with the National Institute for Occupational Safety and Health’s Center for Workers’ Compensation Studies (CWCS).
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Comp Leaders Sound Off on the Year’s Headlines
Louisiana Comp Blog
In 2016, Louisiana Governor John Bel Edwards’ administration installed, the election of a new President, several high profile reports criticizing state workers’ comp systems, and numerous regulatory and rule changes. Louisiana Comp Blog reached out to local and national voices in the comp arena to ask: What was the biggest story of 2016?
Other authorsSee publication -
Return to Work: Work Comp's Unsung Hero
WorkCompCentral (Subscription Required)
Return to work is a potent ally in preventing medical scenarios from becoming unnecessarily complex and causing long-term disability, while fostering over-utilization and over-consumption of treatment and medications. It can, and should, be used proactively as part of treatment regimens to ensure injured workers profit from the therapeutic benefits of the workplace.
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Fending Off the Feds
WorkCompCentral (Subscription Required)
The Department of Labor’s report on workers’ compensation "Does the Workers’ Compensation System Fulfill Its Obligations to Injured Workers?" is the subject of much discussion among stakeholders in the workers’ compensation industry. Does the key to much of what ails today’s workers’ compensation industry lie in the adoption of the value-based health care model?
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Comp Reform Efforts Target Old Concerns
Business Insurance
Despite the insurance industry's focus on emerging issues such as opting out of state workers compensation systems and medical marijuana, the majority of workers comp bills introduced, as of May 2016, involve first responders, medical cost management and the definition of an employee.
Other authorsSee publication
Honors & Awards
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2018 Comp Laude Awards & Gala People's Choice Award Finalist
WorkCompCentral
An engaging session sponsored by Gallagher Bassett, the Comp Laude® People's Choice Awards pursues David DePaolo's vision. He had a passion for new ideas, unconventional thinking and a desire to inspire positive change in the industry by breaking barriers.
After a call for submissions, seven candidates have been chosen to share their unique stories on Oct. 10 in a “TED Talk-style” format. The 2018 Comp Laude ® People's Choice Awards presenters are as follows:
Brian Allen - Vice…An engaging session sponsored by Gallagher Bassett, the Comp Laude® People's Choice Awards pursues David DePaolo's vision. He had a passion for new ideas, unconventional thinking and a desire to inspire positive change in the industry by breaking barriers.
After a call for submissions, seven candidates have been chosen to share their unique stories on Oct. 10 in a “TED Talk-style” format. The 2018 Comp Laude ® People's Choice Awards presenters are as follows:
Brian Allen - Vice President, Government Affairs, Mitchell
Brittany Busse - Medical Director of Telehealth, Kura MD, Inc.
David Langham - Deputy Chief Judge, Florida
Carlos Luna - VP of Marketing & Business Development, Risico
Kristy Sands - Vice President – Marketing & Communications, Gallagher Bassett
Marques Torbert - CEO, Ametros
Bill Zachry - Senior Fellow, The Sedgwick Institute -
Thursday Thought Leader
LegalNet, Inc.
Thursday Thought Leaders features industry leaders finding ways to improve the efficiency and effectiveness of the the field they work in.
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Recognized as a New Leader in Workers' Compensation
WorkCompWire
WorkCompWire publishes "It's About Time - Value-Based Care Comes to Workers' Compensation" and recognizes Carlos Luna as a new leader in the workers' compensation industry.
Languages
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Spanish
Native or bilingual proficiency
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English
Native or bilingual proficiency
Organizations
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Hispanic Insurance and Risk Management Association (HIRMA)
Board Officer, Vice President
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HIRMA offers education, professional development, networking and leadership opportunities to its associates. The association also provides mentoring and support within a broad-based insurance and risk management network. Associates of HIRMA stay active by attending quarterly educational roundtable luncheons that cover topics such as surveillance, settlement strategies, ergonomics, return to work and absence management, managing the risk of recreational marijuana in the workplace and workers' compensation medical cost containment. HIRMA coordinates popular networking events bringing together leaders in the practice of risk management, insurance, claims management, safety, and human resources.
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Colorado Professionals in Workers' Compensation
Board of Directors (Communications)
-Founded in 1986, The PWC Association, a non-profit, bi-partisan organization, has dedicated itself to providing and promoting networking and education within the Colorado Workers’ Compensation community. The PWC also fosters additional respect for its constituents and the Colorado Workers’ Compensation system as it is a resource for businesses, insurance adjusters, human resource professionals, insurance brokers as well as medical and legal professionals.
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International Association of Industrial Accident Boards and Commissions (IAIABC)
Member of the Research and Standards Committee, Disability Management and Return to Work Committee, and Medical Issues Committee
-Founded in 1914, the IAIABC has been providing information and education on workers' compensation policy, regulation, and administration. Today, the Organization is the largest trade association of workers' compensation jurisdictional agencies in North America. Along with these government entities, various private organizations involved in the delivery of workers' compensation coverage and benefits also participate in the IAIABC. The IAIABC works to improve and clarify laws, identify best…
Founded in 1914, the IAIABC has been providing information and education on workers' compensation policy, regulation, and administration. Today, the Organization is the largest trade association of workers' compensation jurisdictional agencies in North America. Along with these government entities, various private organizations involved in the delivery of workers' compensation coverage and benefits also participate in the IAIABC. The IAIABC works to improve and clarify laws, identify best practices, develop and implement standards, and provide education and information sharing. They strive to gather the best resources available to solve the practical administrative and regulatory challenges of its members.
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The Southern Association Of Workers’ Compensation Administrators (SAWCA)
Member of the Claims Administration Committee and Medical and Rehabilitation Committee
-SAWCA provides an environment where meaningful interaction, education, and collegiality among state regulators from 21 jurisdictions across the south. Legislators, academics, constituents, and industry professionals also bring their various perspectives and resources together for the advancement and ongoing improvement of their respective workers' compensation systems.
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