Workers' Compensation

Georgia Senate Bill 135 Adds Exceptions to the 400 Week Limit for Future Medicals – Overview and WCMSA Impact

Georgia Senate Bill 135 (SB 135) was signed into law on May 7, 2019 and makes notable changes to Chapter 9 of Title 34 of the Official Code of Georgia Annotated related to workers’ compensation. These new changes will...

Longshore Act - Medicare Alert: Court Rules that Claimant’s Action for “Double Damages” Was Premature

An interesting new case out of California is a reminder that payers of claims pursuant to the Longshore and Harbor Workers’ Compensation Act (“Longshore Act”) need to stay vigilant for potential “double damages” actio...

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 regulations, new legislation,...

CMS Releases New WCMSA Reference Guide (Version 2.9)

The Centers for Medicare and Medicaid Services (CMS) has just released their latest version of the WCMSA reference guide Version 2.9 (January 4, 2019 ).      These new updates include the following: Development letter...

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 the Centers for...

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 life expectancies in...

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 dollar threshold...

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 decades, severity has...

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’ secondary payer...