Archives

The Five Percent Rule and the Review

12.14.2018 Blog
Most workers’ compensation practitioners and claims handlers know that the Workers’ Compensation Review Contractor (WCRC) for the Centers for Medicare and Medicaid Services (CMS) conducts an independent review of Workers’ Compensation Medicare Set-Aside proposal submissions.

Answers by Amy

11.1.2018 Blog
Question:  How much does the Medicare Secondary Payer program really impact the Medicare program?  Does it really make it more likely that Medicare will be around when I am old enough to qualify for this entitlement program?

Not So Fast MSPA Claims

11.1.2018 Blog
In response to the question whether the Medicare Secondary Payer statute preempted the state’s automobile no fault law, the State of Florida Third District Court of Appeal responded with an emphatic No!

UR: What Is It Good For?

11.1.2018 Blog
You may have asked that question lately. In the management of workers’ compensation claims, Utilization Review (UR) provides a process whereby proposed treatment is assessed for medical necessity and reasonableness.