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Opioids and America’s Workers’ Compensation System

As more entities study the impact of America's opioid crisis, reports are emerging that reveal a tragic tale unfolding for not just the addicts, but also the communities in which they live. The cost of the epidemic is born across several segments of society, and, because those segments also impact non-opioid affected people, essentially, everyone [...]

By |2018-10-03T14:55:35+00:00October 3rd, 2018|Opioid Series, Opioids|

America’s Opioid Epidemic: How it Impacts Work Comp

CompEx MSA is proud to provide this primer series on America's opioid epidemic to help its colleagues and fellow community members be more aware of the problem and mindful of what they can do to avoid contributing to it in the future.   Part One: What it is and how it got started The 'opioid [...]

By |2018-08-29T11:37:24+00:00August 29th, 2018|Opioid Series, Opioids|

Two Bills Favor MSA Appeals Restructure

If Congress passes one or both of two bills presently sitting in congressional committees, then parties to a workers’ compensation (WC) case may finally have a solution to a problem that has plagued that system since its inception. Each of the two proposed bills originates in the separate chambers, and both appear to share a [...]

By |2018-08-29T11:23:57+00:00August 29th, 2018|MSA, Review Process|

Evolving CMS Controls on Opioid Prescriptions

Despite notable guidance available in other arenas, more than two thirds (69.4%) of California's submitted WCMSA proposals include extended funding for opioid medications. The statistic is startling considering that Medicare itself does not recommend using opioids for long-term use or chronic pain. The National Alliance of Medicare Set-Aside Professionals (NAMSAP) and the National Council of [...]

By |2018-08-01T10:32:46+00:00August 1st, 2018|CMS, MSA, Opioids|

AZ SB 1100 – Speeding the Process of Settlement

Arizona has taken a step toward fully resolving the medical coverage uncertainties that linger when its workers suffer injuries on the job. While many workers’ compensation (WC) injuries resolve relatively quickly, others take longer to respond to treatment in both the acute and post-acute phases, resulting in an extended recovery period and higher healthcare costs [...]

By |2018-06-28T10:16:03+00:00June 28th, 2018|MSA, Settlement|

Nebraska Revises WCMSA Approval Process

The Mandatory Second Payer Act (MSP) prohibits the Centers for Medicare and Medicaid Services (CMS or Medicare) from making injury-related payments for Medicare beneficiaries if there's another carrier or provider with a primary obligation to do so. When working to settle an injury claim by a Medicare beneficiary, the parties to the case must take [...]

By |2018-05-31T12:23:00+00:00May 31st, 2018|CMS, MSA, Review Process, Settlement|

Double Damages? Where’s the Risk?

Federal law protects the funding used by Medicare to cover healthcare costs of injured beneficiaries. When another entity - a primary insurance or healthcare plan (the primary payor, or PP) - has a legal obligation to cover those costs, the Medicare Secondary Payor Act (MSP) authorizes Medicare to obtain reimbursement from that PP entity of [...]

By |2018-04-30T09:36:21+00:00April 30th, 2018|Settlement|

Accounting for MSA Drug Price Hikes

In almost all Workers’ Compensation (WC) cases, the Medicare Set-Aside account (MSA) includes a certain percentage of funding to cover the pharmaceutical expenses that are involved in many recovery protocols. MSAs related to more significant injuries such as loss of limbs or temporary or permanent disabilities often reserve the highest financial value specifically for drugs [...]

By |2018-03-29T13:46:34+00:00March 29th, 2018|MSA, Opioids|

CMS Offers Narrow Exception for State Laws

The Centers for Medicare and Medicaid Services (CMS) may be allowing an exception to the federal rule that asserts no state law will supersede its jurisdiction under any circumstances. An updated Reference Guide for Worker's Compensation Medicare Set-Aside Arrangements (WCMSA) version 2.6, suggests that CMS may be more willing than before to let state law [...]

By |2018-03-01T13:17:39+00:00March 1st, 2018|CMS, MSA|

Will the New CRC Contractor Impact Your Business?

Since October 2015, the recovery of Medicare health care payments from both Group (GHP) and Non-Group Health Providers (NGHP) has been managed by CGI Federal. CGI is the first contractor for the Centers for Medicare and Medicaid Services (CMS) Commercial Repayment Center (CRC), which collects back from third-party entities provisional payments made by Medicare on [...]

By |2018-01-31T10:36:31+00:00January 31st, 2018|Uncategorized|