Workers Compensation Topic

10/11/2023 - 24 min read

CMS’s Section 111 Penalties “Final Rule” Released – Breaking Down CMS’s Penalty Provisions and How They Impact Section 111 Reporting

In an important development, CMS has released its Section 111 penalties “Final Rule” --- CMS penalties will go live in 60 days.

10/10/2023 - 2 min read

An Award-Winning Effort Breaks New Ground in Medical Record Review

Verisk leaders earn Technology Innovation honoree status in the 2023 PC360 Insurance Luminary program for their work on Discovery Navigator

9/28/2023 - 16 min read

OIRA Issues New Notice Regarding Section 111 Civil Money Penalties - Notice Addresses the Proposed Rule’s Economic Impact Designation

As many will recall, earlier this year the (CMS) extended the timeline to release its Section 111 civil money penalties (CMP) “Final Rule” until February 18, 2024.

9/18/2023 - 4 min read

CMS announces increase to Maximum Settlement Amount for Fixed Percentage Demand Calculation Option starting October 2, 2023

CMS has announced that effective October 2, 2023, the maximum total settlement amount for the Fixed Percentage Demand Calculation Option.

9/11/2023 - 33 min read

The Minnesota Supreme Court rules that a TPLF agreement’s 60% “repurchase rate” is not subject to MN’s usury statute; remands case back to the district court to determine if this rate is “unconscionable” (and, thus unenforceable) under common-law

One of the issues regarding TPLF concerns whether the interest rates charged by litigation funders can be considered excessive, or legally unenforceable.

8/30/2023 - 1 min read

Verisk Casualty Solutions attends 77th Annual WCI Conference in Orlando, Florida!

Last week Verisk Casualty Solutions proudly attended the 77th Annual Workers' Compensation Educational Conference and 34th Safety & Health Conference in Orlando, FL!

8/8/2023 - 9 min read

CMS releases NGHP User Guide (Version 7.3) – updates include changes to the ORM trigger and CMS’s Unsolicited Response File process

The (CMS) has released an updated Section 111 NGHP User Guide (Version 7.3, August 7, 2023) regarding Section 111 reporting related to non-group health plans

8/7/2023 - 12 min read

The United States District Court for Connecticut dismisses a Medicare Advantage claim for “double damages” – rules that insurer’s Section 111 reporting not sufficient to establish standing

Interesting new Medicare Advantage recovery case, the United States District Court for Connecticut in MSP Recovery Claims, Series LLC v. Travelers Indemnity Company

7/19/2023 - 7 min read

ESG claims – TPLF’s next frontier?

This is a continuing study of emerging Third-Party Litigation Funding (TPLF) issues.

5/18/2023 - 4 min read

CMS releases the WCMSA Reference Guide Version 3.9

CMS has made various updates to different aspects of its WCMSA process, including removing the time limit on Amended Reviews.

5/16/2023 - 16 min read

Harnessing AI and ML through Discovery Navigator to save time and money on medical records review

Understand the vital role of AI in automating record reviews and how it addresses current industry challenges.

11/16/2022 - 4 min read

CMS releases updated Workers’ Compensation Medicare Set-Aside Reference Guide (Version 3.8) – changes impact CMS’s WCMSA re-review process

The Centers for Medicare and Medicaid Services (CMS) has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.8)

9/8/2022 - 4 min read

COVID-19 and Workers’ Compensation in 2022: The Great Resignation and Closing the Talent Gap

We continue our look at how the COVID-19 pandemic continues to impact workers’ compensation.

5/23/2022 - 4 min read

COVID-19 and Workers’ Compensation in 2022: Legislative Update and Clearing Presumption of Coverage Hurdles

After two years, COVID-19 continues to impact workers’ compensation claims. In previous entries, we provided a broad look at the industry.

1/13/2022 - 5 min read

New Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5) takes aim at non-submit and EBMSAs

Centers for Medicare and Medicaid Services (CMS) has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5, January 10, 2022).