Our office recently received several questions regarding the proposed Explanation of Benefits (“EOB”), as well as the current Department of Insurance Rules concerning electronic billing in Workers’ Compensation claims.

Welcome to the Summer 2019 edition of the Medicare Secondary Payer Compliance Corner.

In Duncan v. Liberty Mutual Insurance Company, 2019 U.S. Dis. LEXIS 106265, the U.S. District Court for the Eastern District of Michigan found that a decedent’s Estate (“Plaintiff”) did not have standing to seek double damages against Liberty Mutual (“Liberty”), the decedent’s no-fault PIP carrier. 

Medicare Secondary Payer (MSP) compliance is a detailed, somewhat complicated, and often dynamic field. MSP law and regulations are constantly evolving and subject to some interpretation.

A Medicare Set-Aside (MSA) is a settlement tool used by parties to prevent a cost shift of future injury-related Medicare covered expenses to Medicare when the settlement terms close out liability for future medical.

Section 25.5 of the Illinois Workers’ Compensation Act (820 ILCS 305/25.5) governs workers’ compensation fraud in Illinois. 

Jim Moran will be presenting "50 Hacks in 50 Minutes: Highly-Original and Creative Claims Tips" at the 2019 Conference in Las Vegas, NV November 6-8.

It is well recognized in the disability and healthcare literature that the longer amount of time an injured employee stays off work, the lower the chances are for a successful recovery and return to work.

On December 7, 2018, the Appellate Court of Illinois issued a Decision in William Pisano v. The Illinois Workers’ Compensation Commission (City of Chicago), 2018 IL App (1st) 172712WC, which sheds further light on awards for permanent partial disability in cases where multiple accidents and injuries are at issue, and a wage loss results as one of the cases.

On May 20, 2019, the Illinois Workers’ Compensation Medical Fee Advisory Board announced a Proposed Amendment to the Workers’ Compensation Commission’s Administrative Rules.