U.S. House of Representatives Introduce Workers' Compensation Medicare Set-Aside Legislation

• 08/26/19
• Jean S. Goldstein

You may recall that in 2018 we reported that a Senate Bill was introduced, “[t]o amend title XVIII of the Social Security Act to provide for the application of Medicare secondary ...
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WCMSA Legislation Introduced Again in U.S. House of Representatives

• 08/22/19
• Heather Schwartz Sanderson

We have blogged on numerous occasions regarding Workers’ Compensation Medicare Set-Aside (WCMSA) legislation that continues to be re-introduced in Congress with slight variations over the last decade ...
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Rousmaniere: Insuring Hazardous Jobs

• 08/21/19
• Peter Rousmaniere, Gyana Singh

What a difference a generation makes in dangers at work. Since the mid 1990s, the incidence of lost time injuries was cut in half. Yet dangerous jobs remain. What are they?  If you look at fatality ...
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CMS Updates Unified Agenda Regarding Date for Civil Monetary Penalty Provisions for MSP Reporting Requirements

• 08/13/19
• Jean S. Goldstein

Last week, we provided an update that the Centers for Medicare and Medicaid Services (CMS) updated the Unified Agenda as related to the proposed rulemaking for guidance regarding how to satisfying Medicare ...
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Rousmaniere: Worn Out Workers

• 08/07/19
• Peter Rousmaniere

Mark Walls and Kimberly George are on to a good idea. They say we should be aware of how personal predicaments influence recovery from work injury.  In May they said that “social determinants of ...
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First Circuit, Mass. Court: Assignee of Medicare Advantage Plan May Bring Private Cause of Action for Double Damages

• 08/01/19
• Jean S. Goldstein

In July, the United States District Court for the District of Massachusetts issued a ruling on a Motion to Dismiss and Motion to Strike Class Allegations involving an insurance carrier and a Medicare ...
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District Court Indicates That First Circuit May Allow Medicare Advantage Organizations to Sue Primary Payers for Double Damages under the MSP Act

• 07/24/19
• Heather Schwartz Sanderson

The Wild Wild West of Medicare Advantage Organizations (MAOs) filing litigation nationwide against primary plans (workers’ compensation, liability or no-fault carriers/plans) to establish the right to ...
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Why Workers'Recovery?

• 07/23/19
• Claire Muselman

The workers’ compensation industry needs a serious pep talk. Many have lost sight of the original intent of workers’ compensation: to take care of the injured worker. When messaging is added in ...
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CMS Issues Proposed Decision to Cover Acupuncture for Medicare Beneficiaries

• 07/18/19
• Jean S. Goldstein

This week, the Centers for Medicare & Medicaid Services (CMS) issued a proposed decision to cover acupuncture for Medicare patients with chronic low back pain (cLBP) who are enrolled ...
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