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Vol. 4, Issue 9

Find Solutions & Strategies                             March 4, 2013

Smart Act Medicare Secondary Payer
  
The shape of things to come in 2013
 
In This Issue
-MEDICARE SECONDARY PAYER IN 2013
-LARSON SPOTLIGHT: Undocumented Worker, Employee Status, Borrowing Employer, Third Party
-BLOGS: Fraud, Home Health Care, Repackaged Drugs, Mold Exposure
-SMART ACT ANALYSIS
-NATIONAL NEWS
-STATE NEWS
-eNEWSLETTER ARCHIVES
 A Note From the Editor
Robin Kobayashi 2010 
Dear Work Comp Community:

 

Thanks to Jennifer C. Jordan, Esq. at MEDVAL, LLC for her contributions to this week's eNewsletter. 

 

To sign up for this free weekly eNewsletter, click here. To read past issues, access the archives.

 

Sincerely,
Robin E. Kobayashi, JD
LexisNexis Legal & Professional Operations
medicare secondary payer

Jen Jordan March 2010 thumbnailMedicare Secondary Payer: The Shape of Things to Come, by Jennifer C. Jordan, Esq. 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, have found more of the same subjective and irrational determinations we endured with the old contractor but without the familiarity and predictability. So with new law to implement and additional personnel and contractor changes anticipated at CMS this year, the uncertainty of what this year holds in store for us is greatly compounded. Guess we can only wait and see. Meanwhile, here is what you have been missing since we went to press for the 2012 edition of The Complete Guide to Medicare Secondary Payer Compliance (LexisNexis). Read more.

larson's on undocumented worker

Tom Robinson thumbnailUndocumented Worker's Permanent Loss of Earning Capacity, by Thomas A. Robinson. Citing Larson's Workers' Compensation Law, the Supreme Court of Nebraska recently held that an employee's illegal residence or work status does not bar an award for permanent loss of earning capacity, even when the worker relocates to the community of his origin where no data exists to support a finding as to the worker's post-injury earning capacity. The court reasoned that...Read more about this case and other cases on Employee Status, Borrowing Employer, and Tort Action Against Third Party.

lexisnexis workers' comp law community

Fraud SignWorkers' Comp Fraud Blotter: Former Official's Claim of Illiteracy Fails at Suppression Hearing. Read it and other news items.   

 

  

 

 

1652 SealCalifornia: Home Health Care Service Now and Then, by Calif. WCAB Noteworthy Panel Decisions Reporter Staff. Read it.

 

 

 

 

CWCICWCI Study Measures Outcomes for Claims with Physician-Dispensed Repackaged Drugs. Read it. 

  

 

 

 Cassandra

A River Runs Through It...... Not in this Little Ditty about Mold Exposure in Delawareby Cassandra Robert, Esq. Read it.
new emerging issues analysis
Dollar Sign Blue
Jennifer C. Jordan on Strengthening Medicare and Repaying Taxpayers Act (SMART Act), 2013 Emerging Issues 6924 (additional fees may apply to lexis.com subscribers). All others can purchase the article online at the LexisNexis Store. This expert commentary summarizes and analyzes the SMART Act signed into law by President Barack Obama on January 10, 2013. The SMART Act, which amends the Medicare Secondary Payer Act, seeks to alleviate Medicare conditional payment burdens in a great number of simple liability insurance settlements as well as ease the procedures for mandatory insurer reporting requirements.
national news
State news

CA: AB 1309 Would Bar Specified Retired Pro Athletes From Seeking Calif WC Benefits.

CA: AB 1010 Would Publish WC Insurer Financial Statements Online.

CA: SB 626 Addresses SB 863 Provisions on IMR, Chiropractors, Psychiatric Disorders.

CA: AB 322 Would Require Licensing, Regulation of Home Health Care Providers.

CA: AB 638 Would Establish Priority Conferences for Employees of Uninsured Employers.

CA: SB 487 Would Establish Self-Insured Group Security Fund.

CA: AB 517 Would Deposit Penalties Against Educational Institutions Into WC Revolving Fund.

CA: SB 527 Would Extend Leave of Absence Entitlement to Lifeguards in City of San Diego.

CA: DWC Audit Unit Warns Payors Must Negotiate in Good Faith With Potential Lien Claimants.

CA: DWC Posts Fee Schedule Changes for Hosp. Outpatient Depts,, Ambulatory Surgical Ctrs.

CA: DWC Posts Updated Time of Hire Pamphlet.

CA: WCIRB Classification & Rating Committee Posts March 5 Meeting Agenda.

CA: Former Pro Football Players Seek to Overturn Arbitration Decision re WC Benefits.

CA: CWCI Continues Case Law Series With 2013 Update.

CO: Columnist Warns HB 13-1025 Could Increase Workers Comp Premiums.

CT: Lawmakers Forge Ahead With Workers Comp Mental Trauma Bill.

FL: Court Strikes Down 1994 Workers Comp Reform re 104 Week TTD Indemnity Limit.

FL: HB 831 Would Change Enforcement Procedures for PDMPs.

GA: House Passes HB 178 to Restrict Licensing of Pain Management Clinics.

IL: Doctor Says Workers Comp System Not a Level Playing Field.

IL: Springfield Reports $1.4M Reduction in Workers' Comp Costs.

IN: House Passes HB 1320 Hospital Fee Schedule Changes.

IA: HF 274 Would Modify Alternative Care Procedures for Medical Treatment.

KS: Senate Passes SB 187 Re ALJ Nomination and Appointments Process.

LA: LWCC Issues Largest Dividend in History to Policyholders.

LA: OWC Publishes Electronic Medical Billing and Payment Companion Guide (p. 105 of PDF).

MO: New Plan in Works to Keep Paying Second Injury Fund Lawyers.

NH: LGC Faces Dilemma of How to Repay $17,1M to Cities, Towns.

NH: LGC Members Advised re No Collective Repayment of $17.1M Order.

NY: SWCB Announces Medical Treatment Guideline Program Improvements Go Live.

NY: SWCB Announces Availability of eClaims Trading Partner Registration, Revised Tables.

NC: SB 43, SB 44, SB 51 Claims Study, Data Disclosure & Collection Passed by Senate.

OH: BWC Introduces Rules to Accelerate Reforms of Self-Insured Dept.

OH: March 14 Hearing to Finalize Restitution Amounts Owed by BWC to Ohio Businesses.

OK: Senate Passes Workers Comp Reform.

OK: House Plans to Make Modifications to Workers Comp Reform Bill.

OK: House Committee Approves Bill to Privatize CompSource Oklahoma.

OK: Senate Passes SB 522 Restrictions on Compounding Pharmacies.

OK: Attorney General Urges Businesses to Report Workers Comp Fraud Big and Small.

OR: Feb 2013 Final Version of 2012 State Premium Rate Ranking Report Now Available.

SC: WCC Withdraws Proposed Rule Change Re Oral Argument Arrival Time.

TN: Top Dem Lawmaker Slams Governor for Hurting Workers With Proposed WC Reforms.

TX: Two Bills Filed to Privatize Texas Mutual Insurance.

TX: Governor Reappoints Rod Bordelon as Commissioner of Workers' Compensation.

TX: DWC Posts Feb. 2013 Safety & Health Update.

VA: Lawmakers Table HB 1612 Fee Schedule Changes.

VA: Lawmakers Table HB 2206 Prompt Payments to Health Care Service Providers.

 

ENEWSLETTER ARCHIVES

ArchivesTake a deep dive into our past eNewsletters for 2013 and prior...warning - some links to articles may not work...report any linking problems to Robin.E.Kobayashi@lexisnexis.com.

Feb. 25, 2013: Why Workers Settle Their Claims.

Feb. 19, 2013: Larson's and the Ambiguous Statute.

Feb. 11, 2013: Supreme Court Rejects "Anything That Floats" Test.

Feb. 4, 2013: Workplace Wellness Programs Return on Investment, Implementation Tips.

Jan. 28, 2013: Depression: The Hidden Cost of Compensable Work Injuries.

Jan. 22, 2013: Workplace Homicide.

Jan. 14, 2013: Opting Out Is the New "In" Thing.

Jan. 7, 2013: The Top 10 Bizarre Workers' Comp Cases for 2012.

ACCESS 2010-2012 ARCHIVES AND ARTICLES LIST HERE.

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