Claims

Five Steps to Reduce Your WCMSA Costs

It is no secret that high Workers’ Compensation Medicare Set Aside (WCMSA) allocation amounts can complicate claim settlement. The culprits can range from the Centers for Medicare and Medicaid...

New Kentucky Workers’ Compensation Law Limits Treatment to 780 Weeks for Certain Claims

On March 30, 2018, Kentucky House Bill (HB-2) was signed into law which makes major changes to the Kentucky workers’ compensation statute. The most significant addition is language that limits...

CMS’ Medicare Beneficiary Identifier initiative and its Medicare Secondary Payer impact

Starting in April, the Centers for Medicare and Medicaid Services (CMS) will begin replacing all Medicare cards with a new unique 11-byte Medicare Beneficiary Identifier (MBI) number. The change is...

CMS Releases WCMSA Reference Guide (Version 2.7)

The Centers for Medicare and Medicaid Services (CMS) has released its latest WCMSA Reference Guide (Version 2.7). This is CMS’ ninth release of the guide to date. A copy of CMS’ new reference guide...

Texas Court: Medicare Advantage Plans Can Sue for Private Cause of Action under the Medicare Secondary Payer Statute

In Humana v. Shrader , 2018 WL 1384529 (S.D. Tex. March 16, 2018), the federal district court ruled, in part, that the private cause of action (PCA) provision under the Medicare Secondary Payer (MS...

Medicare Advantage Update: Connecticut Court Rules MAPs Can Pursue “Double Damages” Under the Medicare Secondary Payer Statute

Connecticut is the latest jurisdiction to address whether Medicare Advantage Plans (MAPs) have private cause of action (PCA) rights to pursue “double damages” under the Medicare Secondary Payer (MS...

Reference Guide to Florida Verifications

When a crash occurs in Florida, the state sends an FR1/FR100 “Liability” Sanction Verification to the auto insurance carriers of the motorists involved in the incident. Florida advised carriers to confirm coverage for crash verifications if a motorist’s insurance policy meets the state’s minimum liability requirements, even if the VIN is registered in another state.

Oklahoma Plate Scanners

Oklahoma has contracted with the vendor Gatso USA to scan (using cameras) motorists’ license plates to determine whether auto insurance coverage is in place. The plates will be matched against the state’s verification system. If the vehicle is found to be uninsured, the owner will be mailed a citation with a penalty of $184. Motorists who pay the fine will not have a charge of driving without insurance on their permanent record.

New Strategy to Reduce Uninsured Driver Rate

The Insurance Research Council (IRC) estimated Oklahoma’s uninsured driver rate to be 26 percent in 2012, the highest in any state. Though this most recent estimate is five years old, there is little evidence the rate has dropped significantly.