Senate confirms Price as health secretary as ACA fight nears

  • By Ingle
  • 10 February, 2017
  • Comments Off on Senate confirms Price as health secretary as ACA fight nears

After Price, the Senate will turn to efforts to confirm Steven Mnuchin FEB 10, 2017 | BY ANNA EDNEY, ZACHARY TRACER, ARIT JOHN (Bloomberg) — The U.S. Senate confirmed Tom Price, a … Continue Reading →


Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN)

  • By Ingle
  • 3 February, 2017
  • Comments Off on Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN)

by Karen Ingle The Social Security Number Replacement Initiative (SSNRI) is officially underway. This Initiative came from the MACR Act of 2015. According to the Medicare Access and CHIP Reauthorization … Continue Reading →


Colorado Bill would cover injured workers of uninsured employers

  • By Ingle
  • 27 January, 2017
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by: Kristen Beckman, BusinessInsurance.com A Colorado bill seeks to establish a fund that would cover claims for workers injured while working for employers who do not carry workers compensation insurance. … Continue Reading →


LMSA Timeline, Potential WCMSA Re-Review Increase and Current Status of The WCRC

  • By Ingle
  • 24 January, 2017
  • Comments Off on LMSA Timeline, Potential WCMSA Re-Review Increase and Current Status of The WCRC

by Lori Socha, RN, BBA, MPS, CMSP Items noted in WCRC Review Contractor Solicitation Notice Liability Medicare Set-Asides change timeline CMS seems willing to table LMSAs for at least the next … Continue Reading →


CMS Recovery Practice Ruled Improper under the MSP

  • By Ingle
  • 11 January, 2017
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AUTHOR:MARK POPOLIZIO In an important new case—CIGA v. Burwell, 2017 WL 58821 (C.D. California, January 5, 2017)—the court ruled that the CMS practice of seeking full reimbursement of a medical … Continue Reading →


2017 CMS to revisit the “Re-Review” of otherwise approved WCMSA

  • By Ingle
  • 21 December, 2016
  • Comments Off on 2017 CMS to revisit the “Re-Review” of otherwise approved WCMSA

The Centers for Medicare & Medicaid Services recently revisited the task of reviewing its process for addressing requests for CMS to “re-review” otherwise approved Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) … Continue Reading →


CMS Announces Change in Reporting Thresholds

  • By Ingle
  • 16 December, 2016
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Medicare Secondary Payer Mandatory Reporting Provisions in Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (See 42 U.S.C. 1395y(b)(7)&(b)(8)) Change in Reporting Thresholds for Certain Liability … Continue Reading →


Dealing with the Horrific…More states are offering workers’ comp benefits to first responders suffering from post-traumatic stress.

  • By Ingle
  • 14 December, 2016
  • Comments Off on Dealing with the Horrific…More states are offering workers’ comp benefits to first responders suffering from post-traumatic stress.

By: Katie Kuehner-Hebert | December 14, 2016 • 7 min read  More states are offering workers’ comp benefits to first responders suffering from post-traumatic stress. More and more states are … Continue Reading →


2017 Change in Reporting Thresholds

  • By Ingle
  • 13 December, 2016
  • Comments Off on 2017 Change in Reporting Thresholds

CMS-Alert-12.16.16 TPOC Changes December 12, 2016 Medicare Secondary Payer Mandatory Reporting Provisions in Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (See 42 U.S.C. 1395y(b)(7)&(b)(8)) Change … Continue Reading →


Federal bill could ease Medicare Part D reimbursements

  • By Ingle
  • 20 October, 2016
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By Louise Esola 10/17/2016 2:12:00 PM A federal bill could help make it easier for workers compensation payers to determine how much they must pay to reimburse Medicare Part D … Continue Reading →


CMS Updates Medicare Secondary Payer Recovery Portal

  • By Ingle
  • 19 October, 2016
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AUTHOR:SHAWN DEANE On October 11, 2016, the Centers for Medicare and Medicaid Services (CMS) released a new, updated version of the Medicare Secondary Payer Recovery Portal (MSPRP) User Guide. A … Continue Reading →


Opioids and the Injured Worker

  • By Ingle
  • 19 October, 2016
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Like föra cost containment, IWPharmacy is working to bring attention to the epidemic of opioid use in the Workers’ Compensation arena. IWPharmacy has published a white paper titled “Opioids and the … Continue Reading →


Medically Speaking – Marijuana and Pain Management White Paper

  • By Ingle
  • 18 October, 2016
  • Comments Off on Medically Speaking – Marijuana and Pain Management White Paper

Marijuana and Pain Management  Robert Goldberg, MD, FACOEM, Chief Medical Officer, Healthesystems “Are physicians ready to embrace this brave new world of medical marijuana? Recent developments in the legalization of … Continue Reading →


Conditional payment disputes mired in Medicare appeals backlog

  • By Ingle
  • 11 October, 2016
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AUTHOR:SHAWN DEANE Insurers seeking appeals of adverse conditional payment decisions are finding that their cases are dragging, thanks to a major backlog of pending Medicare appeal requests. The Strengthening Medicare … Continue Reading →


A False Choice

  • By Ingle
  • 10 October, 2016
  • Comments Off on A False Choice

In working with our clients in states where marijuana is legalized for medical and/or recreational use, there is a fair amount of concern and discussion. We are watching this closely … Continue Reading →


Conditional payment disputes mired in Medicare appeals backlog

  • By Ingle
  • 10 October, 2016
  • Comments Off on Conditional payment disputes mired in Medicare appeals backlog

AUTHOR:SHAWN DEANE Insurers seeking appeals of adverse conditional payment decisions are finding that their cases are dragging, thanks to a major backlog of pending Medicare appeal requests. The Strengthening Medicare … Continue Reading →


NGHP Alert – New EXCLUDED Diagnosis Codes

  • By Ingle
  • 28 September, 2016
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Financial Services Group                                                       … Continue Reading →


MSP Statute Extends Its Reach in the 11th Circuit: Foreshadowing for Liability MSAs?

  • By Ingle
  • 18 August, 2016
  • Comments Off on MSP Statute Extends Its Reach in the 11th Circuit: Foreshadowing for Liability MSAs?

AUTHOR:KATE RIORDAN AUGUST 18, 2016 In our first blog post on this topic, we outlined the new and emerging risks and complications presented by Medicare Advantage Plans (MAPs). As previously … Continue Reading →


Removing Impediments to Settlements: Conditional Payments in Liability Claims

  • By Ingle
  • 16 August, 2016
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AUTHOR:SHAWN DEANE  AUGUST 16, 2016 While the Commercial Repayment Center’s (CRC) conditional payment process has received a lot of coverage in the last eight months, its collections apply only to … Continue Reading →


Breaking News: 11th Circuit Rules Medicare Advantage Plans Can Sue in Federal Court

  • By Ingle
  • 12 August, 2016
  • Comments Off on Breaking News: 11th Circuit Rules Medicare Advantage Plans Can Sue in Federal Court

AUTHOR:MARTIN CASSAVOY AUGUST 12, 2016 In a broad ruling released on August 8, the Eleventh Circuit Court of Appeals expanded the rights of Medicare Advantage Organizations (MAOs) to use Federal … Continue Reading →


Medicare announces participants in effort to improve access, quality of care in rural areas

  • By Ingle
  • 5 August, 2016
  • Comments Off on Medicare announces participants in effort to improve access, quality of care in rural areas

FOR IMMEDIATE RELEASE August 4, 2016 Contact: CMS Media Relations (202) 690-6145 | CMS Media Inquiries Today, the Centers for Medicare & Medicaid Services (CMS) announced the participants in the … Continue Reading →


Gender Considerations in Workers’ Compensation

  • By Ingle
  • 28 July, 2016
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  Click HERE for the original article.


Comp, retaliation ruling under question

  • By Ingle
  • 27 July, 2016
  • Comments Off on Comp, retaliation ruling under question

By Donna Mahoney 7/27/2016 4:10 pm A recent Ohio Supreme Court interpretation of a statute that protects an employee who files a workers comp claim from being fired in retaliation … Continue Reading →


Medicare and Medicaid Program Integrity Report to Congress

  • By Ingle
  • 21 July, 2016
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July 20, 2016 By Shantanu Agrawal, M.D. Deputy Administrator and Director, Center for Program Integrity  $42 Billion Saved in Medicare and Medicaid Primarily Through Prevention Today, CMS released a report … Continue Reading →


Obama expected to sign act aiming to chip away at opioid woes

  • By Ingle
  • 20 July, 2016
  • Comments Off on Obama expected to sign act aiming to chip away at opioid woes

By Donna Mahoney 7/20/2016 4:18 pm President Barack Obama is expected to sign an opioid and heroin abuse bill aimed to address the nation’s narcotic epidemic by giving states the … Continue Reading →


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