Workers' Compensation

Changes on the Horizon for Workers’ Compensation Claims with IAIABC EDI Release 3.1

The International Association of Industrial Accident Boards and Commissions (IAIABC) develops standards for the Electronic Data Interchange (EDI) of workers’ compensation claims. Today, a growing...

CMS and Opioid Medications - Will CMS Address Opioids in 2018?

Ever since Center for Medicare & Medicaid Services (CMS) started to individually price medications in early 2009, prescription medications, especially opioid medications, have become major cost...

GAO Denies WCRC Bid Protests

In July 2017, CMS awarded the Workers’ Compensation Review Contract (WCRC) bid to Capitol Bridge, LLC. The WCRC is tasked with reviewing and approving WCMSA submissions. In response to CMS’ award,...

CMS Maintains its $750 Low Dollar Threshold for 2018

The Centers for Medicare and Medicaid Services (CMS) has released a new Alert entitled “2018 Recovery Thresholds for Certain Liability Insurance, No-Fault Insurance and Workers’ Compensation...

The CMS WCMSA "Amended Review Process" New Opportunity to Reduce WCMSA Allocations and Settle Claims

For years, the Centers for Medicare and Medicaid Services (CMS) has refused to consider medical evidence postdating the original submission date of a Workers’ Compensation Medicare Set-Aside (WCMSA) proposal.

Expansion of Medicaid Secondary Payer Poses New Compliance Challenges

After numerous delays, it appears inevitable that the expansion of Medicaid Secondary Payer rights will begin on October 1, 2017. The 2013 Bipartisan Budget Act (H.J. Res. 59; Pub. L. 113–67) included the provision to enable states to recover Medicaid expenditures from an entire settlement amount, rather than just those dollars apportioned to medical expenses, as previously held by case law. However, legislative delays resulted in implementation being postponed from October 1, 2014, to this year.

Countdown to “Full and Final” Settlements: Arizona S.B. 1332

The recent passage of Arizona Senate Bill (S.B.) 1332 provides Arizona claims payers with unprecedented opportunity, finally, to close out their workers’ compensation claims. Under this new law, parties will now be able to reach “full and final” settlement of certain workers’ compensation claims beginning October 31, 2017.

Integrating for Excellence: ISO Workers’ Compensation Solutions Now Part of ISO Claims Partners

ISO Claims Partners and ISO Workers’ Compensation (WC) Solutions have joined forces. Our customers will benefit from improved analytics, integrated data platforms, and a better user experience. The...

What’s Next for the WCRC? New Contract Awarded to Capitol Bridge, LLC

Since the Workers’ Compensation Review Contractor (WCRC) contract renewal process began in December 2016, the industry has been awaiting news: whether Provider Resources, Inc. (PRI) would be renewe...

Al Faber Receives IAIABC NextGen Award for Workers’ Comp Achievements

We are pleased to announce that the International Association of Industrial Accident Boards and Commissions (IAIABC) has selected Alfred Faber, director and division head of ISO Workers’ Compensati...