Workers' Compensation

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...

Drug Formularies Continue to Expand in Workers’ Comp Systems

Balancing rising medical and pharmaceutical costs with appropriate and timely treatment for injured workers has been an ongoing struggle for workers’ compensation professionals. But recent trends...

Millennial impact: Preparing for the generational shift in workers’ comp

Workplace demographics are rapidly changing, and if insurers don’t prepare, they’ll face significant challenges. Millennials will make up 75 percent of the workforce by 2025. [1] For insurers, this...

Workers’ Compensation Medicare Set Aside Legislation Filed, Referred to Committee

On June 18, 2018, Senators Rob Portman (R-OH) and Bill Nelson (D-FL) introduced legislation aimed at reforming the Centers for Medicare and Medicaid Services’ (CMS) Workers’ Compensation Medicare...