Workers Compensation Topic

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).

3/12/2021 - 4 min read

The COMP Act is reintroduced in the U.S. Senate

On 3/10/21, Senators Ben Cardin (D-MD) and Rob Portman (R-OH) introduced the Coordination of Medicare Payments and Workers’ Compensation Act (COMP Act) (S. 653) into the United States Senate.

10/6/2020 - 1 min read

CMS releases new WCMSA Reference Guide (Version 3.2)

On 10/5/20, CMS released its latest version of the WCMSA Reference Guide, Version 3.2. This guides replaces version 3.1, released on 5/11/20.

7/8/2020 - 6 min read

Seven steps to closed: Maximizing claims settlement projects

There's a thin and potentially costly line between settling a claim and keeping it open. Using a claims settlement project can help close claims faster.

4/6/2020 - 1 min read

COVID-19 – ISO Claims Partners keeping you updated

As the industry (and nation) continue to deal with the challenges of the current health crisis,we want to provide you with some resources which you may find helpful.

3/30/2020 - 9 min read

Settling claims in unsettling times

In a time of social distancing and uncertainty, many are left wondering how our current working and social paradigm will impact workers’ compensation claims handling – especially being able to close claims.

11/15/2019 - 4 min read

Litigation insights offer the key to rising claim costs

Legal analytics make it possible for insurers to derive actionable insights from legal data to improve claims handling and litigation outcomes.

10/29/2019 - 5 min read

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 increased almost every year for auto and workers’ compensation medical and indemnity claims.

10/11/2019 - 8 min read

Ninth Circuit: CIGA is not a “primary payer” under the MSP and does not have to reimburse Medicare

In a significant new case out of California, the United States Circuit Court of Appeals (Ninth Circuit)[1] in California Insurance Guarantee Association (CIGA) v. Azar, 2019 WL 5076945 (9th Cir. Oct. 10, 2019) reversed the United States District Court for the Central District Court of California [2] and ruled that CIGA is not a “primary plan” under the Medicare Secondary Payer (MSP) statute and, therefore, not liable to reimburse Medicare conditional payments made on behalf of workers’ compensation claimants.

9/13/2019 - 9 min read

The new indemnity data call – are you ready?

The NCCI new indemnity data call initiative is scheduled to launch in Q2 of 2020, with the certification and testing process slated to begin in Q1 of 2020.

8/1/2019 - 3 min read

WCMSA RX update – FDA approves first generics of Lyrica

On 7/22/19, the FDA announced it approved the first generics of Lyrica. This comes at a critical time as CMS has increasingly been including Lyrica in WCMSAs

2/13/2019 - 10 min read

Top 10 Medicare Secondary Payer trends in 2019

MSP compliance is rapidly evolving – policy changes, stricter regulations, new legislation, and emerging case law are making compliance more complex.

11/21/2018 - 3 min read

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 amount pursuant to Section 202 of the Strengthening Medicare and Repaying Taxpayers (SMART) Act of 2012.

8/14/2018 - 1 min read

Workers’ compensation medicare set-aside companion bill filed in House of Representatives

On July 26, 2018, H.R. 6619- Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act of 2018 in the U.S. House of Representatives were introduced.

8/14/2018 - 6 min read

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 indicate a positive change for the industry.