Hear what our attorneys are saying

27
Jan 2020

Avoiding Medicare Secondary Payer Compliance Settlement Term Traps

By Rasa Fumagalli     

  Medicare is a secondary payer when a primary payer is available and has a demonstrated responsibility to make payment. Under the Medicare Secondary Payer statute and regulations, a “primary plan’s responsibility for payments may be demonstrated by a judgment, a payment conditioned upon the recipient’s compromise, waiver of release (whether or not there is
Read the full article…

Read More
27
Jan 2020

Unintended Medicare Consequences from Workers’ Compensation Claim Handling

By William Delaney     

  Medicare exposure can be significantly impacted by claim decisions made early in the handling of a workers’ compensation case. Medicare is a secondary payer to an applicable workers’ compensation insurance plan meaning that Medicare should not be paying for past and future treatment that is compensable under workers’ compensation. If Medicare does pay for
Read the full article…

Read More
27
Jan 2020

Ask Amy

By Amy Bilton     

  This Ask Amy topic comes from one of my workers’ compensation cases.  An MSA was priced by a vendor about 6-½ months ago.  We have the updated medical records, which demonstrate the treatment regimen is the same as it has been for the last year: the Petitioner remains on the same medications and the
Read the full article…

Read More
17
Dec 2019

Closing That Monster File Lurking in the Corner

By Cody Hartman     

  It’s important to recall the Illinois Workers’ Compensation Act generally provides a triad of benefits for an injured worker. Those benefits are: payment of medical bills, payment for time off-work, and permanency benefits. Therefore, all issues precluding resolution stem from these three components. Smaller components such as concurrent employment, or who will assume liability for certain medical bills, can
Read the full article…

Read More
05
Dec 2019

CMS UPDATE! TOWN HALL MEETINGS SET FOR CRC RECOVERY ISSUES AND CMS UPDATES LOW-DOLLAR THRESHOLDS

By Paul Pasche     

  Today, CMS announced two town hall meetings taking place on January 14, 2020, to discuss topics related to recovery processes of the Commercial Repayment Center (CRC), the branch of CRC responsible for collecting reimbursement of Medicare conditional payments from insurance carriers and self-insured entities. On that date at 1:00 PM EST (12:00 PM CST),
Read the full article…

Read More