Vol. 7, Issue 25

Find Solutions & Strategies June 20, 2016

Compromise and Release and Medicare Set-Aside: Informed Consent and Assumption of Risk

In This Issue

* C&R, MEDICARE SET-ASIDE

* EVIDENCE-BASED MEDICINE

* UR DETERMINATION

* NEWS: New benefit rates

* eNEWSLETTER ARCHIVES

A Note From the Editor

compromise and release and medicare set-aside: informed consent and assumption of risk

Liability for future medical treatment for a work related condition cannot be transferred to Medicare without its permission

In Alvarenga v. Scope Industries, 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB panel rescinded the WCJ's order approving the parties' Compromise and Release, which included a Medicare Set-Aside (MSA) of $24,079.23 that the parties did not submit to the Centers for Medicare & Medicaid Services (CMS) for approval. The WCAB panel did not adopt the defendant's position that at the time the order approving Compromise and Release was issued there was a mutual mistake by the parties regarding whether or not the MSA required CMS approval. The WCAB panel explained that, while CMS does not require review of an MSA, if the MSA settlement has not been approved by CMS, CMS is not...read more.

JOEM study supports contention that ebm guidelines result in better outcomes for injured workers and reduced costs for employers

First comprehensive study evaluating evidence-based medicine guidelines in comp setting

By Thomas A. Robinson, J.D., co-author of Larson's Workers' Compensation Law

In recent years within the workers' compensation (WC) arena, proponents of evidence-based medicine (EBM) have contended that managing an injured worker's care according to established practice and treatment guidelines results not only in a savings in overall medical care costs, but also in better outcomes for the injured worker. A recent study published in the Journal of Occupational and Environmental Medicine [See Hunt, Dan L., DO, et al., "A New Method of Assessing the Impact of Evidence-Based Medicine on Claim Outcomes," JOEM, Vol. 58, No. 5, pp. 519-24, January 2016], now provides at least some empirical support for that claim...read more.

california compensation cases

Request for Additional Time Extended Time to Issue UR Determination. Lexis.com and Lexis Advance online subscribers can read it here.

california news headlines

CA: DWC to Enforce Lien Claimants' Use of Uniform Assigned Name.

CA: DWC Announces Temporary Total Disability Rates for 2017.

CA: Columnist: California State Bar a Mess, Should Be Split Up.

CA: Former State Senator Pleads Guilty to Corruption Charges.

CA: Lawmakers Approve Bill to Help Stop Opioid Overdoses.

Labor Official Touts 10th Anniv. of Mine Improvement/New Emergency Response Act.

Implant Approved to Help Fight Opioid Dependency.

eNewsletter archives

Take a deep dive into our past eNewsletters for 2015 and prior...warning - some links to articles may not work...report any linking problems to Robin.E.Kobayashi@lexisnexis.com.

June 13, 2016: Failure to Provide RFA to Claims Administrator Found Unreasonable.
June 6, 2016: RFA Submitted by Secondary Treating Physician Triggered UR Process.
May 31, 2016: WCAB Panel Defines Violent Act for Psychiatric Injury.
May 23, 2016: Do Collective Bargaining Agreements Preempt LC 132a?
May 16, 2016: Compromise and Release and Hidden Glitches of Paragraph 3.
CLICK HERE TO ACCESS 2010-2015 ARCHIVES.

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