Historically, workers’ compensation claims in Arizona have been subject to a number of limitations. If additional medical treatment was needed, a claimant could reopen a claim at any time, despite the finality and resolution of the claim. As a result, settlement of workers’ compensation claims in Arizona have been far less common because these claims […] Continue
As you may be aware, on July 10th, here on our blog we announced the quiet release of a change to CMS’ re-review process. However, as we noted at that time, this process was not formalized by CMS, and had simply been released through CMS’ Workers’ Compensation Medicare Set-Aside Portal (WCMSAP). Specifically, through a revised WCMSAP User Guide, […] Continue
On July 6, 2017, Endo Pharmaceuticals issued a statement indicating it would voluntarily withdraw the opioid pain medication, Opana ER, from the market, in response to the Food and Drug Administration’s request one month earlier. As noted in our prior blog post, the FDA requested that Endo Pharmaceuticals withdraw Opana ER from the market, citing concerns of […] Continue
While all eyes (and ears) have been focused on the news, or the lack thereof of news regarding the Workers’ Compensation Review Contractor award, CMS quietly released a change to their re-review process today. The change was released through CMS’ Workers’ Compensation Medicare Set-Aside Portal (WCMSAP). Specifically, through a revised WCMSAP User Guide, which can […] Continue
With the 4th of July holiday, we allowed for some additional time for news of the Workers’ Compensation Review Contractor (WCRC) contract award to be announced. As you know, last week, we were anxiously awaiting the announcement. We were hopeful that this morning, we would wake up to the news that the award had been […] Continue
The California Supreme Court has determined that it will not review a case involving an injured worker who asserted that the Independent Medical Review (IMR) process was unconstitutional. This is good news for California payers, furthering the defensive position that payers can continue to rely on both the Utilization Review (UR) and Independent Medical Review […] Continue
We are currently four months away from CMS implementing their new workflows for Medicare Administrative Contractors (MACs), which outline how they will handle bills when there is a Liability Insurance Medicare Set-Aside Arrangement (LMSA) or No-Fault Insurance Medicare Set-Aside Arrangement (NFMSA) involved in the settlement. You may be aware that, in February 2017, CMS took […] Continue
As reported several months ago, CMS has begun preparation of a new fraud prevention initiative that removes Social Security numbers (SSN) from all Medicare cards. This initiative is the result of the passage of the Medicare Access and CHIP Reauthorization Act of 2015, which mandated the removal of the SSN-based HICN from Medicare cards. Known […] Continue
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
On Wednesday, in the second decision of its kind this month, the United States District Court, Southern District of Florida denied in part and granted in part a Motion to Dismiss in a Medicare Advantage Organization (MAO) Medicare Secondary Payer Act (MSPA) recovery claim. MSPA Claims 1, LLC, et al. v. Century Surety Company, No. […] Continue