Hear what our attorneys are saying

27
Apr 2020

Answers by Amy

By Amy Bilton     

  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.  We also are hearing from clients that they have old cases which seem “stuck” because CMS is asking for additional medical records that do not exist, or which
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27
Apr 2020

Going Abroad with a Future Medical Allocation/Medicare Set-Aside

By Rasa Fumagalli     

  Attorney William Lowry recently wrote about workers’ compensation insurance considerations when Illinois employees are working abroad.  The blog post may be found here.  This blog will look at situations involving tangential issues, i.e. workers’ compensation settlements with future medical allocations or Medicare Set-Asides (MSAs) that will be spent overseas. Although most workers’ compensation settlement
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27
Apr 2020

Medicare Set-Aside Prescription Drug Changes – Some Pills Are a Little Less Bitter

By Amy Bilton     

  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.  Initially, we as an industry priced prescription drugs in a variety of ways: based on actual cost; using mail-order pharmacy prices; or sometimes even using prices from other
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27
Apr 2020

Get “Informed” About the New Consent to Release for Medicare Set-Asides

By Julie A. Garrison     

  Approval of Workers’ Compensation Medicare Set-Asides (WCMSA) by the Centers for Medicare and Medicaid Services (CMS) remains the “gold standard.”  WCMSA funds, first approved by CMS and then properly exhausted, guarantee Medicare will take over as primary payer for further treatment costs.  And while submission of a WCMSA to CMS for approval is voluntary,
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24
Apr 2020

Employer Groups Obtain TRO Against IWCC Emergency Rule

By Adam Cox     

  On April 21, 2020, the Illinois Manufacturers’ Association (IMA) and Illinois Retail Merchants Association (IRMA) filed case 2020 CH 000098 in the Circuit Court of Sangamon County. It consisted of a Verified Complaint and Motion for a Temporary Restraining Order (TRO) and Preliminary Injunction against the Illinois Workers’ Compensation Commission (IWCC) and the Chairman
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