Although our nation is currently focused on the COVID-19 pandemic, the opioid abuse epidemic continues to claim many lives.

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.

Almost every Workers’ Compensation Medicare Set-Aside (WCMSA) includes future diagnostic imaging studies, usually x-rays and MRIs.

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. 

On April 13, 2020, the Illinois Workers’ Compensation Commission created an emergency amendment to Rule 9030.70, expanding the Commission’s Rules of Evidence to include a rebuttable presumption for first responders and front-line workers exposed to COVID-19.

The Centers for Medicare and Medicaid Services (CMS) recently released its long-awaited proposed rule for imposition of mandatory civil penalties to enforce the Mandatory Insurer Reporting program commonly known as “Section 111 Reporting.”

Medical bills often become an issue at the brink of a workers’ compensation trial or settlement.

It’s important to recall the Illinois Workers’ Compensation Act generally provides a triad of benefits for an injured worker.

The act of manually turning a key or using a screwdriver does not require an incredible amount of force.

The “Eggshell Skull Rule” is a longstanding principle in workers’ compensation law.