Coverage in the Age of COVID-19

By |2020-08-03T17:39:14-04:00August 3rd, 2020|Uncategorized|

The COVID-19 pandemic has dramatically changed life around the world, halting whole global industries while shutting down cities, regions, and countries. The necessity of shuttering a company due to the coronavirus has caused immense financial and personal distress in virtually all industrial sectors. Millions of workers no longer have jobs as their employers closed up their business [...]

Will the New CRC Contractor Impact Your Business?

By |2018-01-31T10:36:31-05:00January 31st, 2018|Uncategorized|

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 [...]

Opioid problem, cutting into U.S. life expectancy

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

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 [...]

What Could Happen After Settlement?

By |2017-06-28T13:18:25-04:00June 28th, 2017|MSA, Settlement, Uncategorized|

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 [...]

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

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

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 [...]

CMS Adds LMSA NFMSA Arrangement Rules

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

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 [...]

CMS Overreaches for Reimbursement

By |2017-04-05T16:07:25-04:00February 24th, 2017|MSA, Uncategorized|

The U.S. District Court for the Central District of California (the Court) recently determined that the Centers for Medicaid and Medicare Service (CMS) cannot seek reimbursement from Worker's Compensation (WC) employers or primary insurers for unrelated medical charges when, in a conditional payment case, the health care provider's bill includes codes for medical conditions unrelated [...]