LexisNexis® Legal Newsroom
Off-Label Drugs and Workers’ Compensation Medicare Set-Asides

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL, LLC With the addition of Part D to the Medicare program in 2006, Medicare set-aside allocations (“MSAs”) grew exponentially overnight. The problem was further exacerbated by the April 9, 2009 CMS memo mandating that the preferred method...

MSP Compliance and the Late, Great Jerry Garcia

This year marks the 10th anniversary of the Patel Memo , the memo that launched the Medicare Secondary Payer industry. We are forced to look back over the past decade and recognize just how far we have come. As the late, great Jerry Garcia would say, “What a long strange trip it’s been”...

MSP Compliance and the Late, Great Jerry Garcia

This year marks the 10th anniversary of the Patel Memo , the memo that launched the Medicare Secondary Payer industry. We are forced to look back over the past decade and recognize just how far we have come. As the late, great Jerry Garcia would say, “What a long strange trip it’s been”...

Medications We Frequently See in Workers’ Comp Physician Reports

By Robert G. Rassp, Esq. The following chart lists the brand or common and chemical names of drugs we regularly see in our cases embedded in medical-legal reports, treating physician reports and subpoenaed medical records. Some physicians randomly use the brand names, and others use the chemical name...

Medications We Frequently See in Workers’ Comp Physician Reports

By Robert G. Rassp, Esq. The following chart lists the brand or common and chemical names of drugs we regularly see in our cases embedded in medical-legal reports, treating physician reports and subpoenaed medical records. Some physicians randomly use the brand names, and others use the chemical name...

How California Handles the WCMSA Process

There is a garden industry that has emerged since 1997 in California of companies who have become “WCMSA specialists”, promoting themselves as experts in developing WCMSA proposals that will pass muster with CMS. Most workers’ compensation legal practitioners who represent injured workers...

How California Handles the WCMSA Process

There is a garden industry that has emerged since 1997 in California of companies who have become “WCMSA specialists”, promoting themselves as experts in developing WCMSA proposals that will pass muster with CMS. Most workers’ compensation legal practitioners who represent injured workers...

California WCMSA Case: Did Clinical Need for Medical Treatment Occur Faster Than CMS Process for Approving Medicare Set-Aside?

By Jennifer C. Jordan, Esq. In California, there is a unique trend compared to the rest of the nation in that the Medicare Set-Aside process is primarily defense driven with less than full disclosure to the Applicants. While not applicable to all employers/insurers, it is problem enough that the Applicant's...

California WCMSA Case: Did Clinical Need for Medical Treatment Occur Faster Than CMS Process for Approving Medicare Set-Aside?

By Jennifer C. Jordan, Esq. In California, there is a unique trend compared to the rest of the nation in that the Medicare Set-Aside process is primarily defense driven with less than full disclosure to the Applicants. While not applicable to all employers/insurers, it is problem enough that the Applicant's...

Recent Medicare Set-Aside Changes

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL, LLC Liability Medicare Set Asides Of the series of memos released by CMS on September 30, 2011, the most notable established a policy for when a liability Medicare set-aside (LMSA) would not be required [ see http://www.cms.gov/COBGeneralInformation...

Recent Medicare Set-Aside Changes

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL, LLC Liability Medicare Set Asides Of the series of memos released by CMS on September 30, 2011, the most notable established a policy for when a liability Medicare set-aside (LMSA) would not be required [ see http://www.cms.gov/COBGeneralInformation...

The WCMSA Conundrum in California

By Robert G. Rassp, Esq. The following email string is true, accurate and correct. It is a typical email string between an applicant’s attorney and a defense attorney. We all have cases like this in our inventories. In this case, the Applicant was a medical laboratory technologist who sustained...

The WCMSA Conundrum in California

By Robert G. Rassp, Esq. The following email string is true, accurate and correct. It is a typical email string between an applicant’s attorney and a defense attorney. We all have cases like this in our inventories. In this case, the Applicant was a medical laboratory technologist who sustained...

Love It or Hate It: Medicare Secondary Payer Enforcement Is Here to Stay

By Jennifer C. Jordan, Esq. Progress is the theme of this year’s update to The Complete Guide to Medicare Secondary Payer Compliance , 2012 Edition (available in October; see special offer below). Nothing has improved so much that people don’t still cringe at the mention of MSAs, but after...

National and State-by-State Workers' Comp News Roundup Powered by Larson's (9/4/2012)

Sign up here for our free workers' compensation enewsletters (National or California Edition) to receive weekly news items. Be sure to select the enewsletter of your choice. NATIONAL NEWS: CMS Announces Coverage Change Re TENS Units Included With WCMSA Proposals . SSA Issues New Rules on...

California WCMSA: Separate Settlements for Each Claim - The Benson Case

By Robert G. Rassp, Esq. Appellate review of California Labor Code Sections 4663 and 4664 on apportionment has mandated that physicians provide in their conclusions with reasonable medical probability approximately what percentage of permanent disability or impairment is directly caused by each industrial...

California WCMSA: Separate Settlements for Each Claim - The Benson Case

By Robert G. Rassp, Esq. Appellate review of California Labor Code Sections 4663 and 4664 on apportionment has mandated that physicians provide in their conclusions with reasonable medical probability approximately what percentage of permanent disability or impairment is directly caused by each industrial...

National and State-by-State Workers' Comp News Roundup Powered by Larson's (12/10/2012)

Sign up here for our free workers' compensation enewsletters (National or California Edition) to receive weekly news items. Be sure to select the enewsletter of your choice. NATIONAL NEWS: ABA 2013 Workers’ Comp Midwinter Seminar & Conference to Be Held 3/14-3/16 . Federal Employees...

National and State-by-State Workers' Comp News Roundup Powered by Larson's (2/25/2013)

Sign up here for our free workers' compensation enewsletters (National or California Edition) to receive weekly news items. Be sure to select the enewsletter of your choice. NATIONAL NEWS: IAIABC Responds to Inappropriate Opioid Use Critical to Workers Compensation . CMS Clarifies Re-Evaluation...

Medicare Secondary Payer: The Shape of Things to Come

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL, LLC 2013 is shaping up to be a big year for MSP change. The question is whether that change will be good or bad. Last summer we were hopeful the new WCRC contractor would bring about positive change on the WCMSA front, but after several months...

National and State-by-State Workers' Comp News Roundup Powered by Larson's (4/1/2013)

Sign up here for our free workers' compensation enewsletters (National or California Edition) to receive weekly news items. Be sure to select the enewsletter of your choice. NATIONAL NEWS: 7th Circuit Rejects Liberty Mutual’s Challenge to AIG Class Action Settlement Order . NAIC Ranks...

National and State-by-State Workers' Comp News Roundup Powered by Larson's (4/8/2013)

Sign up here for our free workers' compensation enewsletters (National or California Edition) to receive weekly news items. Be sure to select the enewsletter of your choice. NATIONAL NEWS: Judges Rule AIG/Liberty Mutual Settlement Won’t Adversely Affect Pending Appeal. AIG Reduced...

National and State-by-State Workers' Comp News Roundup Powered by Larson's (4/15/2013)

Sign up here for our free workers' compensation enewsletters (National or California Edition) to receive weekly news items. Be sure to select the enewsletter of your choice. NATIONAL NEWS: Group Calls for State-Run SSI System With Parallel Features of State WC System . NCCI’s 2013...

National and State-by-State Workers' Comp News Roundup Powered by Larson's (5/20/2013)

Sign up here for our free workers' compensation enewsletters (National or California Edition) to receive weekly news items. Be sure to select the enewsletter of your choice. NATIONAL NEWS: Rep. Reichert Files H.R. 1982 Medicare Secondary Payer Workers Comp Bill . AIA Supports H.R. 1982 Medicare...

NCCI Research Brief on Medicare Set-Asides and Workers' Compensation

NCCI has recently examined the demographics related to MSAs (distributions of amounts of MSAs and total settlements that include MSAs; distributions of ages of claimants) and the aspects of the CMS review process (length of time from submission to CMS approval; relation between submitted and CMS-approved...