Sid Wong, J.D.
CRC looks to resolve backload of conditional payment leads
On 8/9/19, the Commercial Repayment Center hosted a conference call to discuss the handling of conditional payment letters versus conditional payment notices.
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
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…
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.
CMS releases new WCMSA Reference Guide (Version 2.9)
On 1/4/19, CMS released their latest version of the WCMSA reference guide Version 2.9.
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…
CMS releases new WCMSA Reference Guide and NGHP Section 111 User Guide
The Centers for Medicare and Medicaid Services (CMS) has updated both its Workers' Compensation Medicare Set-Aside (WCMSA) Reference Guide and its Non-Group Health Plan…
New Kentucky workers’ compensation law limits treatment to 780 weeks for certain claims
On March 30, 2018, Kentucky House Bill (HB-2) was signed into law which makes major changes to the Kentucky workers’ compensation statute.
CMS issues new regulations aimed at identifying and limiting potential opioid abuse
On April 2, 2018, C,S issued a final rule which updated regulations for Medicare Advantage Plans (MAP) and Medicare Part D programs.
CMS releases WCMSA reference guide (Version 2.7)
The Centers for Medicare and Medicaid Services (CMS) has released its latest WCMSA Reference Guide (Version 2.7).
WCMSA update: CMS holds WCRC transition webinar
On March 7, 2018, CMS held a transition webinar regarding its upcoming Workers’ Compensation Review Contractor (WCRC) transition.
WCMSA update: New WCRC takes over March 19th – webinar set for March 7th
CMS has announced that its new Workers Compensation Review Contractor, Capitol Bridge, LLC will assume WCRC responsibilities on March 19, 2018. CMS is holding a…
CMS and opioid medications - Will CMS address opioids in 2018?
Currently, CMS takes a strict formulaic approach that will price all Medicare covered medication related to a claim at the present dosage and frequency for the “duration…
GAO denies WCRC bid protests
In response to CMS awarding the WCRC bid to Capitol Bridge, LLC, KEN Consulting Inc. and Arch System, LLC filed formal bid protests with the Government Accountability…
Medicare Part D - The next recovery frontier?
Spurred by a number of favorable court decisions allowing MAPs to sue for “double damages” under the MSP statute, Medicare Part D plans are now beginning to step into the…