Workers’ Compensation
Social Security Administration suspends processing of third-party requests to determine SSDI status
As of 3/17/20, all the Social Security Administration field offices have been closed to the public in response to the growing COVID-19 pandemic according to its website.…
Starting April 25, 2020, CMS will use the 2017 CDC life table for WCMSAs
In an alert dated 3/17/20, CMS announced beginning 4/25/20, it will use the new 2017 CDC life table to calculate adjusted life expectancies in Workers’ Compensation…
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.
Successful workers’ comp analytics starts with the right plan
Workers’ comp analytics can improve claims process by identifying high-severity claims early, promoting consistency in claim handling, and improving return-to-work…
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…
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,…
CMS will use the 2016 CDC Life Table for WCMSAs starting 10/12/19
On 9/12/19, CMS announced beginning 10/12/19, it will use the new 2016 CDC Life Table to calculate adjusted life expectancies in WCMSAs.
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.
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 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 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…
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.
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…