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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 (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 (4/8/2013)

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 (5/13/2013)

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: Columnist Warns About Loss of State Regulated Workers’ Comp BWC Staffer Defends Ohio BWC Workers...

Williams Mullen Health Care Fraud and Abuse Alert: What CMS’s New Billing Requirement For ‘Incident To” Services Means For Medicare Providers

By Brian C. Vick In the final Medicare Physician Fee Schedule for 2014 (“2014 PFS”), CMS implemented a new condition of payment for “incident to” services that has significant fraud and abuse implications for any Medicare provider who relies on reimbursement revenue from these...

Bradley J. Frigon on the Applicability of Medicare Secondary Payment Subrogation Rights to Medicare Part C and Part D Private Carriers

By Bradley J. Frigon Following several cases that challenged federal regulations, CMS published a memorandum to all Medicare Advantage Organizations and Prescription Drug Plan Sponsors regarding Medicare Secondary Payment Subrogation Rights for Part C and Part D private carriers seeking reimbursement...

This is Real Law: Rx for Litigation: New Inpatient Rule May Lead to More Malpractice Suits

Our circumstances are often defined by fateful decisions. Those decisions can be our own, those made by others (with or without our knowledge or consent), or both. That’s particularly true with regard to our personal health. You climb a wonky ladder to adjust a second-story TV antenna, for example...

Norton Rose Fulbright: CMS Offers New Resources and Guidance on 2-Phase Approach to Sunshine Act Reporting

By: Benjamin Koplin , Selina Coleman and R. Jeffrey Layne The Centers for Medicare & Medicaid Services (CMS) has posted new resources to its "Open Payments" website to clarify its recently announced two-stage approach to registration and data submission. These resources include: ...

Williams Mullen: CMS Proposes Rule That Would Expand Its Authority To Audit Medicare Advantage Plans

By Brian C. Vick O n April 30, 2014, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule to update payment policies and rates for inpatient hospitals (the “Proposed Rule”) that includes a provision with significant future implications for sponsors...

Stumbling Toward a Humanitarian Solution: Donald Kerwin

"[W]e do not yet know the mix of policy, operational and legal responses that will be needed to resolve this situation in a way that vindicates rights, respects the rule-of-law, and protects those in need. Three overarching considerations, however, should be taken into account in working toward...

Norton Rose Fulbright: Physicians Payments Sunshine Act Data 33 Percent Unpublishable, Penalties Next?

By Benjamin Koplin , Selina Coleman and R. Jeffrey Layne Despite extending the dispute-and-resolution deadline to account for the days that the Centers for Medicare & Medicaid Services (CMS) pulled down the reporting system, the public Physician Payments Sunshine Act website is still expected...

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...

Steptoe & Johnson PLLC: CMS Final IPPS Rule Effective Oct. 1, 2014

By Jami K. Suver, Of Counsel In August 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final inpatient prospective payment system (IPPS) rule for fiscal year 2015, applicable to inpatient stays at general acute care and long-term care hospitals (LTCH). The rule applies to discharges...

Norton Rose Fulbright: CMS Offers Settlement Of Inpatient RAC Denials

By Mark Faccenda On August 29, 2014, the Centers for Medicare and Medicaid Services (“ CMS ”) announced that certain providers with pending appeals of specified inpatient-status claims denied by Medicare contractors may elect to receive partial payment on those claims in exchange for the...

Ballard Spahr LLP: Health Plan ID Program Suspended

By Edward I. Leeds Late on October 31, the Centers for Medicare and Medicaid Services (CMS) Office of E-Health Standards and Services announced that it was suspending the program that required all health plans to register for a health plan ID number to be used in certain electronic transactions. This...

Workers’ Compensation and Its Secondary Payers: Medicare and Medicaid

Last November I had the pleasure of participating in a panel with two more eminently qualified folks—Jennifer C. Jordan of MEDVAL, LLC and Tim Nay at Nay & Friedenberg —about Medicare Secondary Payer (MSP) compliance at the 23rd Annual National Workers’ Compensation and Disability...

CMS Releases Database Featuring Estimates and Characteristics of US Unauthorized Immigrants

"The Center for Migration Studies of New York (CMS) announces the release of an innovative database that provides detailed information about US unauthorized residents at the national, state, and sub-state levels." - CMS, Mar. 3, 2015 .

Unlocking Human Dignity: A Plan to Transform the US Immigrant Detention System

" Unlocking Human Dignity: A Plan to Transform the US Immigrant Detention System addresses one of the most troubled features of the US immigration system and highlights the need for fundamental changes to it. The report comes six years since the inception of the Obama administration’s detention...

Barnes & Thornburg: CMS Releases Physician-Level Payment Data Totaling More Than $90 Billion in Medicare Reimbursements for 2013

By Jessica Talati On June 1, the Centers for Medicare & Medicaid Services (CMS) released its second annual installment of Medicare reimbursement data for physicians and other practitioners. The data set contains records for more than 950,000 practitioners who received a collective $90 billion...

Free Event in NYC: Reform of the US Immigrant Detention System (Thurs. Sept. 17, 2015)

Reform of the US Immigrant Detention System - Family Detention, Privatization, and Lessons from the Criminal Justice and National Security Debates Thursday, September 17, 2015 2:00pm to 5:00pm Center for Migration Studies 307 East 60th Street, 6th Floor New York, NY 10022 Free Event [REGISTRATION...

Drop in Undocumented Population Continues

CMS, Jan. 20, 2016 - " In a critical new report released today, the Center for Migration Studies of New York (CMS) finds that the US undocumented population has fallen below 11 million for the first time since 2004. The report also offers evidence that the Mexican-born undocumented population continues...

CMS Finds DACA and DAPA Populations Part of American Society

Center for Migration Studies, Mar. 10, 2016 - " A new paper released today by the Center for Migration Studies of New York (CMS) offers a statistical portrait of the potential beneficiaries of the Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA) program, the original...