Hear what our attorneys are saying

12
Sep 2018

Lyrica: Is It In or Out?

By Rasa Fumagalli     

  Lyrica has been the subject of recent discussions within the Medicare Set-Aside professional community. Submitters have been surprised to find CMS including Lyrica in WCMSA determinations in situations where it had previously been excluded. Since the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide (Version 2.7, March 19, 2018) purports to explain the process
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30
Aug 2018

Introducing “Answers from Amy”

By Amy Bilton     

  Medicare Secondary Payer compliance is an area of practice that is governed by the MSP Statute and supporting Federal Regulations.  In addition to the law, the Centers for Medicare and Medicaid Services (CMS) also publishes the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide.   The application of the MSP Statute to a particular set
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29
Aug 2018

Prioritizing Payments

By Vinal Patel     

  In yet another ruling concerning Medicare Advantage Organizations’ rights to pursue the private cause of action under the Medicare Secondary Payer Act, a U.S. District Court in Illinois held that assignee-organizations may pursue rights of recovery on behalf of assignor-MAOs with valid assignment agreements. MAO-MSP Recovery II, LLC. v. State Farm Mut. Auto. Ins.
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22
Aug 2018

“Moneyball” Comes to Claims Handling

By James A. Moran     

  Having revolutionized how we look at everything from baseball, elections to meteorology, it was only a matter of time before predictive analytics were utilized to better manage workers’ compensation claims. According to a recent Business Insurance article, Rising Medical Solutions spent five years polling “high performing” claims organizations and found that they utilized predictive
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14
Aug 2018

The Effects of Recent Supreme Court Decisions on Employers

By Anne-Marie Foster     

  Epic Systems v. Lewis & Janus v. AFSCME So far, 2018 has marked a major year of U.S. Supreme Court decisions that affect the employer-employee relationship. Two recent decisions of the Court both have an impact on how an employer manages its business and engages with its employees. First, in Epic Systems v. Lewis,
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