On August 19, 2022, Governor Pritzker reappointed all 10 Arbitrators whose terms were expiring: Dennis O'Brien, Edward Lee, Elaine Llerena, Frank Soto, Jacqueline Hickey Haralelli, Michael Glaub, Roma Dalal, William Gallagher, William McLaughlin and Kurt Carlson.

Beginning June 4, 2022, CMS will utilize the CDC’s “Table 1: Life Table for the total population: United States, 2019” for the Workers’ Compensation Medicare Set Aside life expectancy calculations.

The moment Illinois workers’ compensation professionals have been waiting for has finally arrived!  On October 21, 2021, Arbitrator Amarilio issued the first decision addressing Illinois’ COVID-19 presumption in the case of Edgar Lucero v.  Focal Point, LLC (20 WC 18985).

Why would I do a Medicare Set-Aside when an individual has an alternative form of health insurance, whether that be through group health insurance after the age of 65 while working for the respondent-employer or through a spouse?

Prescription drugs can make up a large part of a Medicare Set-Aside.  Since Medicare prices future prescription drugs using average wholesale price, the ultimate cost of the drugs through a pharmacy benefits manager (PBM) is often less than the average wholesale price.

The Office of Management and Budget recently updated the timing for the release of the long-awaited proposed rule addressing liability, no-fault and workers’ compensation settlements.

While development letters (CMS letters asking for additional information for a submitted MSA) have slowed over the last several months, we are still seeing them, nonetheless. 

For those of us who have been doing Medicare Set-Asides for over a decade, CMS’ pricing of prescription drugs has been a difficult pill to swallow. 

This Ask Amy topic comes from one of my workers’ compensation cases.

The Centers for Medicare and Medicaid Services (CMS) just published version 3.0 of their Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide.