Assuming and Terminating Ongoing Responsibility for Medicals: When, What to Report in Section 111

• 09/22/21
• Rafael Gonzalez

Introduction In 2007, Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) added mandatory insurer reporting (MIR) requirements to the Medicare Secondary Payer (MSP) Act at 42 USC ...
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Generational Threat to Insurance

• 09/20/21
• Claire Muselman

Over the past fifteen years, there has been an ongoing dialogue creating a sense of urgency to the transition coming to the insurance space and we are now feeling it. Adding in the pandemic as well as the ...
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Failing to Ensure Complete, Proper Resolution of Medicare Conditional Payment Claims is Very Risky Business

• 09/15/21
• Melisa C. Zwilling

One of the most common and oftentimes difficult issues parties face when settling claims with Medicare beneficiaries is how to best resolve Medicare conditional payment claims.  This is true in ...
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Making the Most of a Functional Capacity Evaluation

• 09/13/21
• Anne Marciniak

Workers’ compensation payers typically use Functional Capacity Evaluations, known as FCEs, to help guide difficult return-to-work decisions. A return-to-work FCE evaluates an injured employee’s ...
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Low Back Pain: A Better Remedy?

• 09/09/21
• Aliza Krug

Core Strength The term “core strength” seems to be one of the most commonly used phrases when discussing health and fitness. Most group fitness classes include a core section or are solely ...
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Specialty Services for Catastrophic Claims

• 09/07/21
• Craig Evans

In workers’ compensation, catastrophic injuries transpire with relatively low frequency. When they do occur, however, payers demand an all-hands-on-deck approach that calls upon specialized experts to ...
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10 Traits of Fabulous Adjusters: The Work Comp Edition

• 09/02/21
• Claire Muselman

Have you ever been on the flip side of a workers’ compensation claim? Where you were the injured worker? If you have not, have you ever put yourself in the injured worker’s shoes? Or had a family ...
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Managing Employee Fears about the COVID Vaccine

• 08/30/21
• George L. Vergolias

As we enter the back half of 2021, roughly 51% of US citizens are fully vaccinated against COVID-19, and another 9.3% are partially vaccinated. (https://ourworldindata.org/covid-vaccinations?country=USA). ...
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PTSD and Workers' Compensation: The Difficulty of a Proper Diagnosis

• 08/25/21
• Lynn Timmons

Recently, there has been increasing discussion about Post Traumatic Stress Disorder (PTSD), not only in the general population but also in the workers’ compensation realm in regards to COVID-19. From ...
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