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July 2011

Medicare Set Aside Compliance Rules Directly From CMS

Medicare Set Aside Compliance Rules -A History and Analysis The Medicare Set Aside compliance rules begin with the MSA Memo from CMS. I have been asked numerous times over the last few months on the status of the Workers Comp Medicare Set asides. Many questions centered around what type of

LinkedIn Workers Comp Group Has 10,000 Members

LinkedIn Workers Comp Group This is the largest LinkedIn Workers Comp Group to date.  Please see the press release for the Workers Compensation based group on LinkedIn. This is one of the discussion groups that I mainly participate in overall. Work Comp Analysis Group Reaches 10,000-member Milestone St. Louis (July

Premium Audits For Public Employers Now Due

Public Employers Workers Comp Audits Now Due The public employers are due for a  premium audit very soon. A large number of our clients are public entities. Most of them are self insured or at least partially self insured. There are still a large number of smaller public employers that

XMods EMods EMR and Credit Scores – Differences

Credit Scores And XMods EMods EMR In my last post, I covered the similarities between XMods EMods EMR and credit scores. This post is about the differences. Some of the differences can be painful. I covered some of the differences in this article. Differences One of the main differences between the

E-Mods X-Mods EMR And Credit Scores – Similarities

Similarities – E-Mods X-Mods EMR And Credit Score A few weeks ago, I posted on E-Mods X-Mods EMR. I received a large number of questions on E-Mods X-Mods, better known as Experience Modification Factors. The questions from the blog readers were the same type that I have seen over the last

Upcoming MSA Crisis Or Should I Say Past?

The Upcoming MSA Crisis Is an MSA crisis upcoming? I am not a Medicare Set Aside Agreement (MSA) expert. There are few people that actually are overall. The one concern I have is that I do not think all participants are compliant with the reporting requirements by the MSA. The

Medicare Set Aside (MSA) Rules – In Nutshell

Medicare Set Aside (MSA) Rules Medicare Set Aside (MSA) rules confuse many people. Recently, I posted on Medicare Set Asides (MSA or WCMSA). I received quite a few questions on how to quickly tell if MSA’s are necessary or not or Workers Comp files. I have seen flowcharts online that

Medical Bills – UC vs Fee Schedule – Are You Overpaying?

Medical Bills U&C  – Overpaying? Are you overpaying for medical bills in U&C or a fee schedule?  I posted my views on medical billing for Workers Compensation in this article. Workers Compensation bills, of course, are processed on a usual and customary (U&C) or a fee schedule basis. There seems

Workers Comp Medicare Set Aside Concerns

Workers Comp Medicare Set Aside (WCMSA) There are a few concerns that I have concerning my last post on Workers Comp Medicare Set Aside. The info from the CMS website is in italics. Annuities  Payout totals for all annuities to fund the above expenses should be used rather than cost

WCMSA – So This Is Not Federalization of Workers Comp ?

WCMSA  = Federalization of Workers Comp? The CMS WCMSA requirements could be the first steps in federalization of Workers Comp.  The last paragraph should be of concern to any carrier, employer or TPA. CMS can change the rules as they see fit as I read it. What happens if they

Will Feds Control Workers Comp In Future or Just States?

Will The Feds Control Workers Comp In 10 Years? In the future,  will the  Feds control Workers Comp. In my last post, I commented on how the Federal Government, namely CMS, is encroaching on the state-by-state sovereignty of Workers Compensation. The CMS is basically overvaluing Workers Compensation pharmacy benefits. The



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