LexisNexis® Legal Newsroom
NY: NYSWCB Posts Revised Inpatient Hospital Care Reimbursement Rates

New York City, NY (CompNewsNetwork) - The workers' compensation fee schedule for inpatient hospital care automatically tracks New York Medicaid rates, as determined by the New York State Department of Health (DOH), with limited statutory modifications. New York Public Health Law § 2807-c(1)...

Physician Fees Will Change - Are You Paying Attention?

Congress and the White House are working to come up with a fix for Medicare's big-and-getting-bigger physician reimbursement (RBRVS) problem. And as I've been saying for months, when (not if) this happens, it will have dramatic effect on health care delivery, health care costs, and insurance...

New CMS Life Expectancy Table Effective July 19, 2010

Lansing, MI (CompNewsNetwork) - The Centers for Disease Control (CDC) has published its 2006 United States Life Tables. Effective July 19, 2010, the Centers for Medicare & Medicaid Services (CMS) will begin referencing the CDC's Table 1: Life table for the total population: United States, 2006...

Medicare Set-Asides and Special Needs Trusts

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL LLC Now that those involved in personal injury settlements, whether workers’ compensation or liability insurance based, have finally come to understand the Medicare Secondary Payer Act (“MSP”) to some extent, it appears that...

Missouri: No Disability for Hunting Trip Accident

Claimant sustained catastrophic injuries from a single car pre-dawn accident in 2008 on a gravel country road when his car went off the road. The parties stipulated that the 30-year old claimant was unemployable but disputed whether his accident arose from his employment when he was found early on a...

Four Reasons to Avoid the CMS Approval Process for MSAs

By Teddy Snyder, Esq., Ringler Associates - Beverly Hills, CA 1. MMSEA reporting makes approval unnecessary for Medicare beneficiaries. Reporting under the Medicare, Medicaid and S-Chip Extension Act, aka “section 111 reporting”, started January 1, 2010 for workers compensation claims...

Four Reasons to Avoid the CMS Approval Process for MSAs

By Teddy Snyder, Esq., Ringler Associates - Beverly Hills, CA 1. MMSEA reporting makes approval unnecessary for Medicare beneficiaries. Reporting under the Medicare, Medicaid and S-Chip Extension Act, aka “section 111 reporting”, started January 1, 2010 for workers compensation claims...

U.S. Supreme Court Upholds Health Care Act - Individual Mandate Is Constitutional, Medicaid Expansion Is Limited

WASHINGTON, D.C. - (Mealey's) In a sweeping opinion covering four issues addressed over three days of oral argument, the U.S. Supreme Court on June 28 found that the Anti-Injunction Act (AIA) does not bar challenges to the Patient Protection and Affordable Care Act (PPACA), that the individual mandate...

Experts, Officials, Media Offer Their Two Cents on U.S. Supreme Court’s Decision on Affordable Care Act

By John Stahl, Esq. The U.S. Supreme Court announcing its decision that the Affordable Care Act, also known as ACA and Obamacare, was constitutional was a “where were you” moment in American history. Key quotes from the majority and dissent opinions are provided below. The experts on...

Cost-Shifting of Workers’ Compensation Expenses: Study Says Third Parties Pick Up Most of the Bill

By John Stahl, Esq. A study that J. Paul Leigh, Ph.D. , and James P. Marcin, MD, MPH conducted addressed cost shifting that occurred when the workers’ compensation system did not absorb the entire cost of a compensable incident. They reported their findings in an article entitled “Workers’...

Ambulatory Surgery Centers: Rapid Growth and Lack of Oversight in California

By John Stahl, Esq. Concern regarding the relatively little public information about heavily utilized ambulatory surgery centers (ASCs) in California prompted the California HealthCare Foundation (Foundation) to research ownership statistics and other data regarding these facilities that service rapidly...

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...

Worksite Wellness Clinics and Reduction of ER Visits: Good News for Employer Health Plan Costs

By Robin E. Kobayashi, J.D., LexisNexis Legal & Professional Operations Emergency room visits and costs are on the rise in the U.S. and expected to get worse with Obamacare according to a recent report which shows people with Medicaid (many of whom have obtained coverage under Obamacare) use ER...