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May 22, 2018

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.

Michael Longmire Lhltmgdohc8 Unsplash
May 9, 2018

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.

Claims Blind Spots
April 25, 2018

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.

Hanson Lu Sq5p00l7lxc Unsplash
March 19, 2018

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.

Neonbrand Jw6r 0cpyec Unsplash 1
February 12, 2018

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.

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January 29, 2018

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…

Quino Al 8gweaaxjjti Unsplash
January 19, 2018

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…

Gavel
January 12, 2018

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)…

Neonbrand Jw6r 0cpyec Unsplash
December 4, 2017

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.

Bill Oxford R2esy7rxb4m Unsplash
December 1, 2017

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.

Lucas Vasques 9vnacvx2748 Unsplash
November 20, 2017

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’…

Headway 5qgiuubxkwm Unsplash
November 20, 2017

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…

Melissa Walker Horn 1081246 Unsplash
September 26, 2017

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.

Antoine Dautry Zsl306fdck Unsplash
September 26, 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.

Dan Dimmock 323873 Unsplash
August 2, 2017

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.

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