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Looking Ahead to 2018

On October 1, 2017, the Centers for Medicare and Medicaid Services (CMS) was scheduled to stop paying for health care services that should, instead, be covered by parties deemed responsible for those damages pursuant to liability and no-fault insurance cases. In early 2017, the agency had announced that Medicare-beneficiary claimants in both liability and no-fault [...]

By |2018-01-03T15:32:28+00:00January 3rd, 2018|CMS, CMS WCRC, MSA, Review Process|

CMS Proposes Opioid-Management Rules

America is struggling to contain its nation-wide opioid epidemic, which has taken thousands of lives and crippled the lives of many thousands more. In mid-2016, President Obama signed the Comprehensive Addiction and Recovery Act (CARA), the first federal law designed to provide a comprehensive, balanced, and coordinated strategy to improve access to and treatment for [...]

By |2017-11-30T09:37:07+00:00November 30th, 2017|CMS, MSA, Opioids|

Meet the Newest CMS WCRC Contractor

There is a new Worker's Compensation Recovery Center WCRC contractor in place as of September 1, 2017. The new contractor is Capital Bridge LLC, headquartered in Arlington VA., which replaces Provider Resources Inc. (PRI). The contract award is notable for several reasons: It comes two months later than its announced date. Since early July, all [...]

By |2017-10-31T14:20:14+00:00October 31st, 2017|CMS WCRC, MSA, Review Process|

Opioid problem, cutting into U.S. life expectancy

Opioid Treatment Offers Hope to Injured Workers Despite increased press coverage and a growing sense of national alarm, America's opioid addiction problem continues to expand. The number of people dying of overdoses each year has skyrocketed so high that it is impacting the calculations that determine the average American lifespan. And tragically, in the majority [...]

By |2017-10-04T12:14:40+00:00October 4th, 2017|MSA, Uncategorized|

CMS Revisions Permit Amended Reviews for MSA

For the first time, parties involved in a Workers' Compensation Medicare Set-Aside (WCMSA) can request a re-review of the MSA value when they dispute the CMS determination or when the financial circumstances of medical care vary from the approved MSA amount by ten percent or $10,000. In the past, insurers, corporations, and injured persons had [...]

By |2017-07-17T12:16:55+00:00July 17th, 2017|MSA, Review Process, Settlement|

CompEx MSA Awarded Minority-Owned Certification

Last month, CompEx MSA National Division LLC (CompEx MSA) received notice that the State of Florida has certified it as a Minority-Owned Florida Certified Business Enterprise. The certification secures our position as a valued vendor of Medicare Set-Aside services within the state and the country and celebrates the fact that our Hispanic American heritage expands [...]

By |2017-07-17T11:18:01+00:00July 17th, 2017|Certification, MSA, Settlement|

What Could Happen After Settlement?

Settling a Workers' Compensation (WC) claim can be a long and arduous journey that many resolve through the establishment of a Medicare Set-Aside (MSA). However, the terms of these legally binding agreements are expected to cover all contingencies over the course of the worker's lifetime. What happens when circumstances change and the conditions of the [...]

By |2017-06-28T13:18:25+00:00June 28th, 2017|MSA, Settlement, Uncategorized|

A Toxic Trio: WC Injury, Chronic Pain, and Opioid Addiction

In April, Health and Human Services chief Tom Price announced that the federal government was issuing to states $485 million in grants for research and development of therapies related to opioid addiction. Funded through the 2015 "21st Century Cures Act," the grants come at a time when America is struggling with a nationwide opioid addiction [...]

By |2017-05-18T18:57:14+00:00May 18th, 2017|MSA|

Georgia’s “400-Week” Rule Perplexes MSA Participants

For almost all of its history, a settled principle of American jurisprudence is that federal law supersedes state law. When there is a question of which body of law should control in any particular case, when applicable, federal law almost always triumphs. The principle holds true for rules involving the Centers for Medicare and Medicaid [...]

By |2017-04-05T16:07:08+00:00March 29th, 2017|MSA, Uncategorized|

CMS Adds LMSA NFMSA Arrangement Rules

In a continuing effort to contain costs and remain fiscally responsible, the Centers for Medicare and Medicaid (CMS) is finally addressing inconsistencies in its payment processes based on the underlying nature of its Beneficiary's health care claims. Beginning October 1, 2017, the agency will launch two new set-aside procedures, one for Liability Insurance injury claims [...]

By |2017-04-05T16:07:17+00:00March 10th, 2017|MSA, Uncategorized|