The United States Supreme Court (SCOTUS) found in favor of the employee group health plan (Marietta) and rejected the dialysis company's (DaVita) claims that the Plan discriminated against patients with ESRD.
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Beginning June 4, 2022, CMS will utilize the CDC’s “Table 1: Life Table for the total population: United States, 2019” for the Workers’ Compensation Medicare Set Aside life expectancy calculations.
Narcan, an opioid antagonist, works by blocking the effects of opioid drugs on the central nervous system.
On January 10, 2022, the Centers for Medicare and Medicaid Services added Section 4.3 - The Use of Non-CMS-Approved Products to Address Future Medical Care to the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide (“Guide”).
On March 2, 2022, the Centers for Medicare and Medicaid Services (“CMS”) submitted a proposed rule on Medicare Secondary Payer and Future Medicals (CMS-6047) to the White House Office of Information and Regulatory Affairs (OIRA), which if adopted could have a game-changing impact on liability, and perhaps other types of cases throughout the country.
Medical bills are often the ugliest part of a workers’ compensation settlement.
Two state insurance guarantee funds challenged CMS’ definition of a “primary plan” in order to exclude themselves from conditional payments and Section 111 reporting requirements.
I recently wrote about Section 111 Total Payment Obligation to Claimant (TPOC) reporting in bifurcated settlements.
Most workers’ compensation claims adjusters would agree that the best claim is a closed one.
The Medicare Secondary Payer Recovery Portal improvements were rolled out on July 13, 2020.