Settlement
Arizona tweaks its "full & final" workers' comp settlement law - New law provides opportunities to settle workers' comp claims
Arizona Senate Bill 1100 provides unprecedented opportunities to settle workers' compensation claims in the state.
Five steps to reduce your WCMSA costs
It is no secret that high Workers’ Compensation Medicare Set Aside (WCMSA) allocation amounts can complicate claim settlement.
Looking beyond the blind spots to get the whole claims picture
Missing details can be key to settling insurance claims. What insurers don’t know can definitely hurt them.
Medicare Advantage update: Connecticut court rules MAPs can pursue “double damages” under the Medicare Secondary Payer statute
Connecticut is the latest jurisdiction to address whether MAPs have private cause of action (PCA) rights to pursue “double damages” under the MSP statute.
Budget Act of 2018 limits Medicaid third-party recovery rights
While most of the headlines focused on the deal’s impact on military expenditures and other issues, the new law also contained an update regarding MSP compliance.
Now hear this: Medicaid Secondary Payer recovery on the rise
Historically, state Medicaid agencies have been rather flat-footed in making efforts to identify and recoup erroneous payments from non-group health entities. In recent…
CMS holds town hall call on CRC transition - CMS provides important updates on ORM recovery transition
On January 18, 2018, CMS held its Commercial Repayment Center Non-Group Health Plan (NGHP) Town Hall presentation to address the upcoming transition of CRC operations…
Medicare Advantage Plans update: Illinois court indicates MAPs have “double damages” rights
Whether Medicare Advantage Plans have private cause of action rights to sue claims payers (and others) for “double damages” under the Medicare Secondary Payer (MSP)…
CMS maintains its $750 low dollar threshold for 2018
CMS has announced that it is maintaining the current $750.00 low dollar threshold in 2018 for certain settlement, judgments, awards or other payments.
Court declines to rule on whether LMSA is necessary - Cites no legal authority for MSAs in liability cases
Whether liability Medicare set-asides (LMSAs) are legally “required” continues to be a vexing question for parties settling liability claims.
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’…
Mind the gap: Filling the experience void in claims settlements
Today, less than a third of the current insurance workforce is under 35 years old, and it’s predicted that more than a quarter of insurance professionals will be…
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.
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 to close out their workers' comp claims.
Making sense of the WCMSA reference guide 2.6
On 7/31, CMS released their new WCMSA Reference Guide. Learn what the changes outlined might mean for submitting WCMSAs to CMS.