The Centers for Medicare and Medicaid Services (CMS) has released the latest edition of its Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements (the Toolkit) (Version 1.3; October 10,...
Workers' Compensation
Ninth Circuit: CIGA is not a “primary payer” under the MSP and does not have to reimburse Medicare
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October 11, 2019
In a significant new case out of California, the United States Circuit Court of Appeals (Ninth Circuit) [1] in California Insurance Guarantee Association (CIGA) v. Azar , 2019 WL 5076945 (9 th Cir. Oct. 10, 2019)...
CMS Releases WCMSA Portal User Guide Version 5.9
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October 10, 2019
The Centers for Medicare and Medicaid Services (CMS) has released the latest edition of its Workers’ Compensation Medicare Set-Aside Portal User Guide (WCMSAP) (Version 5.9; October 7, 2019). CMS outlines its full lis...
CMS Will Use the 2016 CDC Life Table for WCMSAs Starting 10/12/19
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September 17, 2019
In an alert dated September 12, 2019, the Centers for Medicare and Medicaid Services (CMS) announced that beginning October 12, 2019, it will use the new 2016 CDC Life Table to calculate adjusted life expectancies in...
The new indemnity data call – are you ready?
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September 13, 2019
As the fourth quarter settles in, a big change is lurking around the corner: The National Council on Compensation Insurance’s (NCCI) new indemnity data call. Introduced last year, this initiative is scheduled to laun...
Proposed Workers’ Compensation Medicare Set Aside Reform Bill Filed in the U.S. House of Representatives
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August 27, 2019
On August 2, 2019, Representatives Mike Thomson (D-CA) and George Holding (R-NC) introduced legislation aimed at reforming the Centers for Medicare and Medicaid Services’ (CMS) Workers’ Compensation Medicare Set-Aside...
CRC looks to resolve backload of conditional payment leads
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August 22, 2019
On August 9, 2019, the Commercial Repayment Center (CRC) hosted a conference call to discuss the handling of conditional payment letters (CPL) versus conditional payment notices (CPN). On this call, the CRC announced...
Release of proposed “future medicals” rules will be delayed
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August 12, 2019
New notice pushes back release date to October and makes other changes The Centers for Medicare and Medicaid Services’ (CMS) much anticipated release of proposed rules to address “future medicals” in relation to...
WCMSA RX Update – FDA approves first generics of Lyrica
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August 1, 2019
In a July 22, 2019 news release , the Food and Drug Administration (FDA) announced that it has approved the first generics of Lyrica. This announcement comes at a critical time as the Centers for Medicare and Medicaid...
CMS releases new NGHP Section 111 User Guide (Version 5.6)
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July 15, 2019
The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 User Guide (Version 5.6, July 1, 2019 ) regarding non-group health plans (liability, no-fault and workers’ compensation). This...