The Official Medicare Set Aside Blog And Information Resource

CIGA Entitled to Judicial Declaration of Unlawful CMS Interpretation of the MSP

CMS, Medicare Set-Aside Blog, MSP Litigation on May 4, 2017 | Posted by Jennifer Jordan, JD, MSCC

On May 3, 2017, the U.S. District Court for the Central District of California issued its order with regard to CIGA’s entitlement to relief following the court’s award of partial summary judgment in January.  Based upon briefing submitted following that ruling, the Court concluded that CIGA is entitled to:  an order vacating and setting aside […] Continue

HHS Grants to Fight Opioid Addiction: How Could the Grants Impact Your MSA?

CMS, Medicare Set-Aside Blog, Opioids, Rx/Pharmacy on May 4, 2017 | Posted by Jean S. Goldstein, JD

Nationwide, states and workers’ compensation boards have been taking measures to curb the overprescribing and misuse of opioids and the crisis that has ensued as a result.  Nonetheless, opioid addiction continues to be a growing concern.  In an effort to help states combat the opioid epidemic, the U.S. Department of Health and Human Services (HHS) […] Continue

Evidence of Medicare Advantage Organization Not Acting in Medicare’s Best Interests

Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation on May 3, 2017 | Posted by Jennifer Jordan, JD, MSCC

For the past year or so, we have watched courts treat Medicare Advantage Organizations (MAOs) as if they were on equal footing as the federal government acting in the best interest of the Medicare Trust Funds.  The courts have manipulated murky laws and regulations to give MAOs reimbursement rights that Congress did not expressly address […] Continue

MEDVAL BLOG: AWARDED ONE OF THE BEST BLOGS IN THE INDUSTRY

Medicare Set-Aside Blog, MEDVAL News, News and Events on May 3, 2017 | Posted by Jean S. Goldstein, JD

For the second year in a row, MEDVAL has been chosen by workerscompensation.com as one of the best MSP blogs in the workers’ compensation industry.  Blogs were nominated by members of the workers’ compensation community and judged by an independent judging panel of seven highly respected industry leaders.  We want to thank all of our […] Continue

$40 Million Dollars Paid by Insurance Carriers and 13,000 California Patients Affected in an Alarming Kickback Scheme

Fraud, Medicare Set-Aside Blog, Work Comp on April 21, 2017 | Posted by Jean S. Goldstein, JD

Yesterday, 26 defendants (21 doctors, 2 pharmacists, 1 physician assistant, and 2 business owners) were criminally charged in connection with a 40-million-dollar kickback scheme affecting 13,000 California patients statewide.  Two defendants, Tanya King and Christopher King “the Kings”, allegedly masterminded a complex insurance fraud scheme by recruiting both pharmacists and doctors to prescribe medically unnecessary […] Continue

Arkansas Act 1058: What About a Carrier’s Obligations Under the Medicare Secondary Payer Act?

Medicare Set-Aside Blog, MSP News, State Regulations on April 19, 2017 | Posted by Jean S. Goldstein, JD

Senate Bill 760, or Act 1058 (“the Act”) was signed into law on April 7, 2017.  The initial purpose of the Act was to clarify the Workers’ Compensation Death and Permanent Total Disability Trust Fund.  However, the bill was revised to expand the Arkansas Workers’ Compensation Commission’s ability to consider and finalize specific settlements.  Act […] Continue

Comp Laude Award Nominations Are Now Open

Medicare Set-Aside Blog on April 4, 2017 | Posted by Jean S. Goldstein, JD

WorkCompCentral is accepting nominations for its 2017 Comp Laude™ Awards.  The awards recognize integrity, excellence, and success in the workers’ compensation industry.  Each year, nominations are received and reviewed by a panel of industry judges, and awards are presented by WorkCompCentral at the annual Comp Laude® Gala. We encourage you to take a moment to […] Continue

Guaranteeing the Uncertain: Reversions and the ROI on a Structured Annuity

CMS, Medicare Set-Aside Blog, Structured Settlements on April 3, 2017 | Posted by Laura Johnson

The concept of reversions is a topic that surfaces frequently in our structured settlement department.  These clauses can seem confusing, sometimes made more complicated by uncertain futures; however, they are actually straightforward with tangible benefits associated with them.  There are two primary questions we hear the most when clients are asking how they can recover […] Continue

FDA Advisory Committee Finds Opana ER Risks Outweigh Benefits

FDA, Medicare Set-Aside Blog, Rx/Pharmacy on March 21, 2017 | Posted by Erin O'Neill, PA-C, JD

On March 14, 2017, a Food and Drug Administration (FDA) advisory committee found that the risks associated with use of Opana ER (oxymorphone hydrochloride) outweighed the potential benefits. Opana ER is an opioid pain medication, which was first introduced in 2006 and then reintroduced in a new abuse deterrent formulation in 2012. The new formulation was designed […] Continue

Jennifer Jordan, Featured Speaker at the 2017 ALFA International Seminar

Medicare Set-Aside Blog, MEDVAL News, News and Events on March 20, 2017 | Posted by Jean S. Goldstein, JD

This week, Jennifer Jordan, our Chief Legal Officer, will be a featured speaker at the 2017 ALFA International – Workers’ Compensation Practice Group Seminar in Austin, Texas.  Jennifer will be co-presenting with Beth Hostetler of Albertsons-Safeway and will discuss ways to solve Medicare Secondary Payer (MSP) challenges, including ensuring compliance with the Medicare Secondary Payer […] Continue