Ohio Joins State Efforts to Limit Third-Party Litigation Funding

Ohio Joins State Efforts to Limit Third-Party Litigation Funding

Ohio has enacted new rules for third-party litigation funding, expanding oversight of financing firms while stopping short of requiring litigants to disclose outside backing during court proceedings.

Ohio Gov. Mike DeWine signed a bill July 7 that requires litigation finance firms to register with the attorney general and comply with new restrictions, including a ban on foreign investors. Contracts would become public only after a case is resolved.

The law puts Ohio among a growing number of states requiring some form of disclosure or regulation of third-party litigation funding. North Carolina recently went further, banning the practice outright.

Third-party litigation funding allows outside investors with no direct stake in a lawsuit to pay legal costs in exchange for a share of any settlement or judgment. Supporters say the financing can help plaintiffs pursue claims they otherwise could not afford. Critics say the arrangements often lack transparency, can extend litigation, and may leave plaintiffs with only a portion of their recovery while funders take a significant share.

The Ohio measure targets several practices long criticized by businesses and insurers. Consumer litigation finance firms, which often provide cash advances to personal-injury plaintiffs, must register with the attorney general, make detailed disclosures to borrowers, and refrain from paying referral fees to attorneys or medical providers.

Commercial litigation funders face similar limits. Those firms may finance lawyers in exchange for a share of legal fees or back business plaintiffs for a portion of any recovery. Under the law, they must register with the attorney general, may not control litigation decisions, and may not accept foreign money.

The Ohio bill is available here.

WC Litigation and Improving Injured Worker Experience Among Top Challenges Identified by Industry Professionals

Workers’ compensation professionals face a shifting landscape marked by rising claim complexity, cost pressure, and cautious enthusiasm for artificial intelligence, according to a recently released Healthesystems survey.

The survey asked industry professionals to identify their priorities in managing medical programs. Respondents cited improving the injured worker experience, making claims operations more efficient, and better managing complex claims, including those involving patient comorbidities.

Data-driven decision-making also ranked as an emerging priority. Respondents said analytics and actionable insights are increasingly needed to identify trends, detect risk factors earlier, and support more effective interventions.

Poor worker health and comorbidities remain major obstacles. Respondents ranked comorbidities as the top barrier to recovery, the most concerning claim complexity, and one of the leading challenges facing workers’ compensation overall.

Mental health conditions, psychosocial factors, and social determinants of health were also cited as issues that can affect treatment, recovery timelines, and claim outcomes. Respondents said fragmented systems and disconnected data sources often make it difficult to convert available information into timely action.

Respondents ranked workers’ compensation litigation as the industry’s top challenge, while medical and pharmacy costs continued to draw attention. Many also said they want greater transparency into medical and pharmacy spending.

The survey also found cautious optimism about emerging technology, especially artificial intelligence. Respondents said AI could help reduce administrative burden, automate routine tasks, and allow claims professionals to focus on higher-value work. But several respondents also raised questions about bias in AI models and the possible consequences for injured workers if such tools are not carefully designed and monitored.

The survey is available here.

AI Use Impacting WC Market

Workers’ compensation insurers are increasingly turning to AI-driven analytics, predictive triage, workflow automation, and orchestration frameworks to spot escalation risks earlier, improve reserving accuracy, and speed documentation-heavy claims processes, says a new report examining how artificial intelligence is changing the U.S. workers’ compensation insurance market.

The report, Orchestrating Workers’ Compensation in the AI Era, was produced by Sollers Consulting in partnership with Guidewire and CLARA Analytics.

It argues that AI delivers the greatest value when it is built into coordinated operational workflows rather than used as a collection of isolated tools. It highlights applications including claims summarization, fraud detection, predictive triage, and next-best-action recommendations.

The report cautions that AI should support, not replace, human expertise and cites insurance executives who emphasize the need to balance efficiency with judgment, empathy and operational coordination.

The report concludes that the future of workers’ compensation will depend less on individual technologies than on how well insurers connect workflows, systems, AI insights and claims decision-making. As AI becomes more deeply embedded in claims operations, insurers that coordinate these capabilities within a unified operating model will be better positioned to turn technology into measurable advantage.

In the AI era, success will depend not simply on adopting more tools, but on orchestrating them effectively across the claims lifecycle.

The report is available here.

Study Emphasizes Need for Hands-On Performance of Safety Procedures

Gaps in safety performance are not caused by a lack of regulations, but by a failure to make complex standards usable at the point of task, according to a new report from the American Society of Safety Professionals (ASSP).

The report says traditional annual training falls short when it relies on completion rather than demonstrated competency. Instead, it recommends hands-on, task-specific verification to ensure workers can perform critical safety procedures effectively.

ASSP recently convened more than 95 safety professionals and industry experts in Chicago and Washington, D.C., for two working sessions focused on some of the industry’s most persistent hazards: falls from height and failures in lockout/tagout procedures. The result is the Serious Injury and Fatality Prevention Convening Report, which also highlights a need for plain-language instructions, pictograms, and other highly visible tools placed where hazards occur. Participants also emphasized prevention through design, an approach that seeks to eliminate hazards during the design phase rather than relying on workers to manage risks after they emerge.

The report outlines key themes, barriers and proposed solutions identified during the sessions and emphasizes that safety must be treated not only as a compliance obligation, but as an operational priority tied directly to worker protection and business continuity.

ASSP said the next phase of work will involve Standards-Based User Groups, which will help validate the report’s findings, identify additional barriers to implementation, and test practical solutions for applying consensus standards in workplace settings.

The user groups are intended to provide a structured process for turning those insights into practical solutions that improve workplace safety outcomes.

The report is available here.

Report Tracks Medical Price Growth and Drivers for WC

Medical price growth slowed during June, falling to 1% year over year from 1.5% in May and 1.8% in December, according to a report from the National Council on Compensation Insurance (NCCI). The reading remained below the index’s three-year and five-year rolling averages of 2.5%, underscoring continued softness in workers’ compensation medical price growth.

According to NCCI’s quarterly Workers’ Compensation Weighted Medical Price Index (WCWMI), the adjusted Consumer Price Index Medical Care measure rose 3.1% in June, while the Producer Price Index for Health Care Services increased 2.2%. NCCI said medical price growth has largely moved independently of broader inflation trends.

NCCI said the softening in June was driven largely by two components: hospital outpatient care and medicinal drugs. Hospital outpatient care prices, which account for 28% of the medical care details tracked by NCCI, were essentially flat from a year earlier. That marked a decline from 2.1% growth in December and a sharper slowdown from the roughly 4% annual increases NCCI said the category had previously recorded.

Medicinal drug prices, which represent 7% of the tracked components, fell 2.3% year over year in June and have declined for six straight months, according to NCCI. The decline came despite concerns that tariffs would push drug costs higher. NCCI attributed the drop to the Medicare Drug Price Negotiation Program and the proposed Most-Favored-Nation pricing policy, which it said have lowered prices for many commonly used drugs.

NCCI said it expects the WCWMI decline to be temporary and projects the index will rise back toward a range of 2% to 2.5% over the next several quarters.

The report is available here.

Filings Reflect 10-20% Premium Increase Requests by Health Insurers for Small Businesses

Small-group insurers are requesting a median premium increase of 14% for 2027, citing rising medical prices, heavier use of care, and the growing cost of specialty drugs, including GLP-1 medications, according to a Peterson-KFF Health System Tracker analysis of filings from 295 insurers across all 50 states and the District of Columbia.

The filings are preliminary and remain subject to review by state regulators, but they reflect insurers’ own projections of what it will cost to cover small employers next year. The proposed increase exceeds the 11% median request for 2026.

According to Peterson-KFF, GLP-1 drugs are emerging as a particular pressure point. Some plans have dropped coverage for weight-loss use, but costs continue to rise as more diabetes patients use the medications and as the drugs are studied or approved for additional conditions. Benefit focus reported that GLP-1 medications now account for 20.3% of total prescription spending among employer plans, up from 17.5% a year earlier. Members using the medications cost their plans nearly $7,400 annually.

Behavioral health use was another common driver of rate requests. Insurers reported continued growth in mental health and substance use disorder services, and some plans pointed to higher provider reimbursement rates.

According to the filings, 59% of insurers are seeking rate increases of 10% to 20%. The 25th percentile increase was 10%, while the 75th percentile was 18%.

The small-group market typically covers businesses with 50 or fewer full-time-equivalent employees. While some policies are sold through Small Business Health Options Program exchanges, most are purchased directly from insurers.

Insurers in the Affordable Care Act marketplaces have requested a median premium increase of about 14% for 2027, citing rising health care costs and shifts in the market’s risk pool.

More information is available here.

Survey Suggests More Employers Opting for Smaller PBMs

Increasing numbers of U.S. employers are moving from the nation’s largest pharmacy benefit managers (PBMs) in favor of smaller competitors in an effort to control prescription drug spending, according to a new survey by the National Alliance of Healthcare Purchaser Coalitions.

The survey, conducted in May and June among 408 employers, found that 46% were using a PBM outside the three dominant firms, CVS Caremark, Optum Rx and Express Scripts. That figure was up from 37% a year earlier.

Among employers still working with one of the three largest PBMs, 56% said they were considering a change within the next three years. By comparison, 31% of companies already using alternative PBMs said they were weighing another switch.

Employers also projected that their health care costs would rise 7.7% next year.

Previous surveys have shown employers taking a more critical view of PBMs, the intermediaries that negotiate drug prices, manage pharmacy networks, and oversee prescription benefits for health plans.

Beyond lower costs, employers are seeking greater transparency, including broader access to claims data and assurance that PBMs will not use spread pricing, a practice in which PBMs charge plans or employers more for a drug than they pay pharmacies.

The largest PBMs have responded by adopting simpler cost-plus pricing models and returning manufacturer rebates to plan sponsors. Congress also passed new transparency requirements earlier this year and approved changes to how PBMs are compensated.

The report is available here.

Report Shows Increase in Worker Happiness

Employee happiness is rising after four consecutive years of decline, according to a new BambooHR report. The report shows that worker sentiment increased 4.4% from a year earlier to reach its strongest midyear level since 2023.

The company said its platform data also shows a sharp divide in retention: Organizations with happier employees lose 46% fewer workers than those with lower happiness scores.

The rebound, however, is uneven. BambooHR found that employee experience continues to differ by age, gender, tenure and industry. Gen Z workers remain 17 points less satisfied than older colleagues, while the technology sector has slipped from the happiest industry in 2023 to below average today.

BambooHR measures employee happiness using Employee Net Promoter Scores, or eNPS, along with turnover data. The company says eNPS is based on how likely employees are to recommend their organization as a place to work.

Under BambooHR’s scale, a score above zero is considered good, above 20 favorable, above 50 excellent, and above 80 world-class.

The report, based on data from 51,000 employees, found that employee Net Promoter Score, or eNPS, rose to 40 from January through June after four straight years of decline.

The gains were not evenly shared. Workers ages 26 to 30 remained the least satisfied, with an eNPS of 31 — 17 points below the 48 recorded by workers ages 51 to 60. BambooHR also found that male employees reported higher happiness than female employees, though that gap narrowed to 6.8 points from an 8-point average over the previous three years.

The report is available here.

State News

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NFIB
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Islander News
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Florida Employers Could Be Staring Down a Tenth Straight Year of Workers’ Comp Savings
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Carrier Management
Florida AG Charges 7 in $100M Workers Compensation Fraud Scheme
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Attorney General, Jeff Jackson
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Attorney General Jeff Jackson is warning North Carolinians who file workers’ compensation claims of a fraud scheme impersonating government and judicial officials to steal people’s money. Click here for full article.

University of Detroit Mercy
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WorkersCompensation.com
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Human Resources Director
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General News

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Risk & Insurance
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Carrier Management
AI Workflow Coordination is the New Competitive Advantage in U.S. Workers Comp: Report
Anew white paper suggests that AI in workers compensation is best maximized when embedded directly into a framework of coordinated operational workflows rather than deployed as isolated tools or disconnected point solutions, according to international business and IT consultancy specializing in insurance Sollers Consulting, Guidewire and CLARA Analytics. Click here for full article.

Human Resources Director
WCAT Rejects Border Officer’s Psychological Injury Claim Over Debrief Delay
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National Academy of Social Insurance
Workers’ Compensation: Benefits, Costs, and Coverage, 2023 Data
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NCCI
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The Wall Street Journal
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Oak Reile was delivering a pallet of washer fluid, cigarettes and candy to a local convenience store in 2020 when he slipped and fell, breaking two vertebrae and paralyzing him from the armpits down. Click here for full article.

Stars and Stripes
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A judge dismissed a lawsuit from a civilian engineer in the Military Sealift Command after it was determined that her report of being raped in her own bed aboard a Navy transport ship was within her duties and must be treated as a worker’s comp claim. Click here for full article.