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April 17, 2024 · Medicare Insights Team
The Centers for Medicare and Medicaid Services (CMS) released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide Read more... |
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April 10, 2024 · Public Policy & Regulatory Affairs Team
Virginia bill removes medical dispute deadline ‘loophole,’ firefighter cancer coverage expansion bills signed into law; Alabama bill permits providers to bill health insurance first for work comp treatment; Georgia and South Carolina release updated fees schedule, while Louisiana looks to create a medical fee schedule; Maryland General Assembly passes presumption bill; Texas proposes changes to complaint process; Virginia removes timely medical payment dispute ‘loophole’ for older dates of service; Alabama bill permits providers to bill health insurance first for workers’ comp treatment; West Virginia and Wyoming expand workers’ comp firefighter cancer coverage; Oklahoma bill expands mental health coverage to first responders advances; Ohio expands workers’ comp coverage for post-exposure testing; Kansas debates medical marijuana; more on Minnesota workers’ comp PTSD study informational meetings. Read more... |
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March 20, 2024 · Public Policy & Regulatory Affairs Team
Several states update their medical fee schedules, while others propose updates; workers’ comp PTSD and mental health coverage bills pending in many states; expanded cancer coverage likely in Maryland; Florida significantly increases physician reimbursement; Montana clarifies workers’ comp rules; and Texas looks to improve the provider complaint process. Read more... |
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March 11, 2024 · Medicare Insights Team
CMS will update MIR steps RREs must take in reporting Medicare workers compensation TPOCs claims and notifying CMS of WCMSA arrangements. Read more... |
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March 04, 2024 · Public Policy & Regulatory Affairs Team
The California Division of Workers’ Compensation (DWC) proposed significant rule changes in the final phase of integrating its workers’ comp pharmacy reimbursement process into the state’s Medicaid (“Medi-Cal”) pharmacy reimbursement structure. Read more... |
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February 28, 2024 · Public Policy & Regulatory Affairs Team
California corrects drug formulary, Kentucky introduces several work comp bills, Wisconsin bill would establish a work comp medical fee schedule, New York enhances prior auth portal, several other states introduce work comp firefighter coverage and presumption bills, and New Mexico eyes study on treatment with mushrooms Read more... |
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February 07, 2024 · Public Policy & Regulatory Affairs Team
California and Ohio update their work comp drug formularies, while New Jersey expands presumptive coverage for first responders and introduces several new work comp and auto no-fault bills. Read more... |
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January 29, 2024 · Medicare Insights Team
Recent CMS webinar clarifies final rule on civil money penalties for Non-Group Health Plans, describing the triggers for reporting and the auditing process, emphasizing that RREs are required to report claims and that the penalties apply only to prospective claims, and distinguishing between informal and formal notices. Read more... |
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