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MEDVAL BLOG: AWARDED BEST BLOG IN THE INDUSTRY
For the second year in a row, MEDVAL has been chosen by workerscompensation.com as one of the best MSP blogs in the workers’ compensation industry. Blogs were nominated by members of the workers’...
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Evidence of Medicare Advantage Organization Not Acting in Medicare’s Best...
For the past year or so, we have watched courts treat Medicare Advantage Organizations (MAOs) as if they were on equal footing as the federal government acting in the best interest of the Medicare...
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HHS Grants to Fight Opioid Addiction: How Could the Grants Impact Your MSA?
Nationwide, states and workers’ compensation boards have been taking measures to curb the overprescribing and misuse of opioids and the crisis that has ensued as a result. Nonetheless, opioid...
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CIGA Entitled to Judicial Declaration of Unlawful CMS Interpretation of the MSP
On May 3, 2017, the U.S. District Court for the Central District of California issued its order with regard to CIGA’s entitlement to relief following the court’s award of partial summary judgment in...
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New Medicare Cards to Feature New Identifiers
As reported several months ago, CMS has begun preparation of a new fraud prevention initiative that removes Social Security numbers (SSN) from all Medicare cards. This initiative is the result of the...
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Countdown to October – Are You Ready for LMSAs and NFMSAs?
We are currently four months away from CMS implementing their new workflows for Medicare Administrative Contractors (MACs), which outline how they will handle bills when there is a Liability Insurance...
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FDA Requests Endo Pharmaceuticals Withdraw Opana ER From the Market
On June 8, 2017, the Food and Drug Administration (FDA) requested that Endo Pharmaceuticals withdraw Opana ER from the market, citing concerns of ongoing misuse and abuse of the drug. As you will...
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THE UR/IMR PROCESS: STILL GOOD ON ITS FACE.
The California Supreme Court has determined that it will not review a case involving an injured worker who asserted that the Independent Medical Review (IMR) process was unconstitutional. This is good...
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Will the WCRC Award Be Announced Tomorrow?
Tomorrow is June 30. Per the Centers for Medicare & Medicaid Services (CMS), we are expecting that the Workers’ Compensation Review Contractor (WCRC) award will be announced tomorrow. The WCRC is...
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No WCRC Award Announcement… Does This Mean Business As Usual?
With the 4th of July holiday, we allowed for some additional time for news of the Workers’ Compensation Review Contractor (WCRC) contract award to be announced. As you know, last week, we were...
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Eyes on the Prize: A New CMS Re-Review Option is Available.
While all eyes (and ears) have been focused on the news, or the lack thereof of news regarding the Workers’ Compensation Review Contractor award, CMS quietly released a change to their re-review...
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Endo Pharmaceuticals Voluntarily Withdraws Opana ER From the Market: What...
On July 6, 2017, Endo Pharmaceuticals issued a statement indicating it would voluntarily withdraw the opioid pain medication, Opana ER, from the market, in response to the Food and Drug...
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New WCMSA Reference Guide Issued
As you may be aware, on July 10th, here on our blog we announced the quiet release of a change to CMS’ re-review process. However, as we noted at that time, this process was not formalized by CMS,...
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Settling a Case in Arizona? What You Need to Know About Full & Final...
Historically, workers’ compensation claims in Arizona have been subject to a number of limitations. If additional medical treatment was needed, a claimant could reopen a claim at any time, despite the...
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NEW Workers’ Compensation Review Contractor (WCRC) Contract Awarded
Finally, a new Workers’ Compensation Review Contractor (WCRC) award has been issued. This news comes after several months of work being completed by Provider Resources, the incumbent contractor, under...
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Full Medicaid Recovery Coming to a Claim Near You: October 1st
As we have seen, Medicare Advantage Plans, Military/Governmental Healthcare Providers, and Private Insurers are aggressively pursuing liens with a priority right approach to recovery. We often discuss...
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New Medicare Secondary Payer Recovery Contract Awarded
On October 5, the Centers for Medicare and Medicaid Services (CMS) awarded Performant Financial Corporation the Commercial Recovery Center (CRC) contract. The contract was previously awarded to CGI...
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Class Action MAO Recoveries Are Continuing
On August 10, 2017, MSP Recovery Claims, LLC filed a class action complaint against Safeco Insurance Company of America in a Florida Circuit Court. Yesterday, the Defendants filed a request for...
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Another Michigan Spine Case
Opinion out of the U.S. District Court for the Eastern District of Michigan reported on October 13, 2017 shows that the Michigan Spine and Brain Institute is at it again. You may recall that in 2013,...
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Another New Spin in the MAO Class Actions
MAO-MSO Recovery II, LLC, et al., v. Boehringer Ingelheim Pharmaceuticals, Inc., et al. was dismissed for lack of standing on October 10, 2017. In this latest MSP private cause of action stemming from...
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