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FINALLY—The Bid for the Workers’ Compensation Review Contractor (WCRC) Has...
CMS finally issued the solicitation for the Workers’ Compensation Review Contractor (WCRC) to review and evaluate workers’ compensation Medicare set-aside arrangements (WCMSA) submitted to CMS for...
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CMS Special Open Door Forum to be Held
Yesterday, CMS announced that it will hold a conference call, a Special Open Door Forum, on Tuesday, January 17, 2017 at 3:00 pm EST. The call will allow Medicare Secondary Payer stakeholders to learn...
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CMS Releases Updated NGHP User Guide
CMS updated their Non-Group Health Plan (NGHP) User Guide, and released version 5.2. The updated guide can be found here. The only update to the guide is the change in thresholds for reporting certain...
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CIGA Wins Partial Summary Judgment on Issue of Over-inclusive Reimbursements
On January 5, 2017, the U.S. District Court for the Central District of California ruled in favor of the California Insurance Guarantee Association (CIGA) in its ongoing challenges against CMS over its...
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Inclusion of CT Scans Instead of MRI Scans in WCMSAs for Claimants with...
It is commonplace for CT scans to be included in WCMSAs, in lieu of MRI scans, for Claimants with implanted intrathecal pumps; however, little thought is given to the reason for this substitution....
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150 Million Medicare Health Insurance Claim Numbers to be Changed to New...
On Tuesday January 17, 2017, CMS held a special open door forum to discuss the changes and impact of the SSNRI on Medicare Secondary Payer (MSP) stakeholders. Starting April 1st, 2018, CMS will be...
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MSP False Claims Action Reaching Its Conclusion
On January 18, 2017, the Second Circuit Court of Appeals brought an end to Kent Takemoto’s dreams of whistle blower riches. The Court upheld the District Court’s adoption of the Magistrate’s...
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Arymo ER – Latest Addition to the Abuse Deterrent Opioids Market
Last week, the FDA approved Arymo ER, an abuse-deterrent formulation of morphine sulfate extended release tablets, marketed by Egalet Corporation. Arymo ER comes in three dosage strengths: 15mg, 30mg,...
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WCRC RFP Due Date Revised
Yesterday, CMS issued an amendment to the RFP for the WCMSA review contractor. The amendment published responses to questions by offerors, and informed offerors that additional answers to questions...
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California Proposition 64, and Other Marijuana Legislation: Are These...
In 1996, California became the first state to allow for medical use of marijuana. Marijuana is and remains classified as a Schedule I drug, which is defined by the United States Drug Enforcement...
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WCRC RFP Due Date Revised, Again.
CMS just issued an additional amendment to the RFP for the WCMSA review contractor. The amendment published additional responses to questions by offerors, and also a change in the due date for...
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SPARC Act/Part D Prescription Drug Reform Reintroduced. What Does It Mean for...
In September 2016, House Representative Bill 6120 known as the Secondary Payer Advancement, Reconciliation, and Clarification (SPARC) Act was first introduced to Congress. The bill did not pass at...
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CMS to Begin Utilizing 2012 Life Table
CMS posted a notification on their website that they will begin to utilize the CDC’s Table 1: Life Table for the total population: United States, 2012 on April 1, 2017. This means that for any WCMSA...
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MAO Recovery & Courts: Aggressively Pursuing Liens
On Wednesday, in the second decision of its kind this month, the United States District Court, Southern District of Florida denied in part and granted in part a Motion to Dismiss in a Medicare...
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Jennifer Jordan, Featured Speaker at the 2017 ALFA International Seminar
This week, Jennifer Jordan, our Chief Legal Officer, will be a featured speaker at the 2017 ALFA International – Workers’ Compensation Practice Group Seminar in Austin, Texas. Jennifer will be...
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FDA Advisory Committee Finds Opana ER Risks Outweigh Benefits
On March 14, 2017, a Food and Drug Administration (FDA) advisory committee found that the risks associated with use of Opana ER (oxymorphone hydrochloride) outweighed the potential benefits. Opana ER...
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Guaranteeing the Uncertain: Reversions and the ROI on a Structured Annuity
The concept of reversions is a topic that surfaces frequently in our structured settlement department. These clauses can seem confusing, sometimes made more complicated by uncertain futures; however,...
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Comp Laude Award Nominations Are Now Open
WorkCompCentral is accepting nominations for its 2017 Comp Laude™ Awards. The awards recognize integrity, excellence, and success in the workers’ compensation industry. Each year, nominations are...
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Arkansas Act 1058: What About a Carrier’s Obligations Under the Medicare...
Senate Bill 760, or Act 1058 (“the Act”) was signed into law on April 7, 2017. The initial purpose of the Act was to clarify the Workers’ Compensation Death and Permanent Total Disability Trust Fund....
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$40 Million Dollars Paid by Insurance Carriers and 13,000 California Patients...
Yesterday, 26 defendants (21 doctors, 2 pharmacists, 1 physician assistant, and 2 business owners) were criminally charged in connection with a 40-million-dollar kickback scheme affecting 13,000...
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