Workers' Compensation

Top 10 Medicare Secondary Payer Trends in 2019

Medicare Secondary Payer (MSP) compliance is a rapidly evolving area that has experienced significant changes in recent years, and 2019 looks to be no different. Policy changes, stricter regulation...

Proposed Rules for Addressing Future Medical Obligations to be Released

The Office of Information and Regulatory Affairs (OIRA) recently issued a notice entitled Miscellaneous Medicare Secondary Payer Clarifications and Updates (CMS-6047-P) . This notice indicates that...

CMS Will Use the 2015 CDC Life Table for WCMSAs Starting 1/5/19

In an alert dated December 5, 2018, the Centers for Medicare and Medicaid Services (CMS) announced that beginning January 5, 2019, they will use the new 2015 CDC Life Table to calculate adjusted li...

CMS Retains $750 “Low Dollar” Threshold for 2019

The Centers for Medicare and Medicaid Services (CMS) has released its low dollar recovery threshold for 2019 via an alert dated November 15, 2018. CMS is generally required to publish an annual low...

As claim severity climbs, analytic insights hold key to containment

Insurers today are struggling with what seems like an intractable problem: the impact of rising claim severity on their bottom line. This upswing shows no sign of abatement: for the past two decade...

CMS Updates its Medicare Prescription Drug Benefit Manual – New Changes Encourage Part D Collection and Recovery

The Centers for Medicare and Medicaid Services (CMS) has amended its Medicare Prescription Drug Benefit Manual (Part D Manual) to add, in part, stronger language regarding Medicare Part D sponsors’...

CMS Releases New WCMSA Reference Guide and NGHP Section 111 User Guide

The Centers for Medicare and Medicaid Services (CMS) has updated its Workers' Compensation Medicare Set-Aside (WCMSA) Reference Guide and Non-Group Health Plan (NGHP) Section 111 User Guide . These...

CMS Hosts Medicare Secondary Payer Recovery Portal (MSPRP) Webinar

On August 16, 2018, the Centers for Medicare and Medicaid Services (CMS) hosted a webinar focusing on its Medicare Secondary Payer Recovery Portal (MSPRP). The MSPRP is CMS’ web-based application...

Workers’ Compensation Medicare Set-Aside Companion Bill Filed in House of Representatives

On July 26, 2018, Representative David Reichert (R-WA) and Representative Mike Thompson (D-CA) introduced H.R. 6619- Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act of...