News & Analysis as of

Medicare Workers' Compensation Claim

Weber Gallagher Simpson Stapleton Fires &...

[Webinar] 2024 New Jersey Workers’ Compensation Case Law Updates - April 29th, 12:00 pm - 1:00 pm ET

Join partners Cheryl Binosa, Jeffrey Newby, and Renee Porada Frazier for an insightful webinar that will cover several pressing topics in New Jersey Workers' Compensation, based on recent cases in the state. In this...more

Laughlin, Falbo, Levy & Moresi LLP

A NEW MEDIC-ERA; Changes to CMS Review Guidelines in 2025

Vast changes are swiftly approaching regarding the efforts Workers’ Compensation practitioners must make in protecting Medicare’s interests in future medical settlements. The Centers for Medicare/Medicaid Services (CMS) has...more

Stark & Stark

Understanding Workers’ Compensation Costs and Fees in New Jersey

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This is a common question, and it is necessary to fully understand the costs and fees that will be deducted from your award as you consider a potential settlement or are reviewing a judgement by a Judge of Compensation. The...more

Marshall Dennehey

Appellate Division Affirmed Workers’ Compensation Order Finding an Increase in Permanency, but Not Total Disability.

Marshall Dennehey on

Hughes v. Port Auth. of N.Y. & N.J. and State of N.J. Second Inj. Fund, No. A-1188-22 (Jan. 30, 2024) - In this case, the Appellate Division affirmed the workers’ compensation order for an increase in the petitioner’s...more

Marshall Dennehey

Beware of the Language Used in Your Settlement Agreements: Medicare Is Watching

Marshall Dennehey on

The workers’ compensation practitioner has now become a forced bedfellow of CMS, like it or not. If you fail to “issue spot” in relevant settlements, you will have problems. Reprinted with permission from the October 2,...more

Dorsey & Whitney LLP

The Supreme Court - June 22, 2022

Dorsey & Whitney LLP on

Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., No. 20-1641: This case concerns the interpretation of the Medicare Secondary Payer Act’s (MSPA) anti-discrimination provisions regarding individuals with...more

Weber Gallagher Simpson Stapleton Fires &...

Medicare Clarifies Position on Use of “Non-submit” or “Evidence-based” WCMSA Allocations

On January 10, 2022, Medicare published the Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide, Version 3.5. Included in the Reference Guide is a new section, Section 4.3 The Use of Non-CMS-Approved Products to...more

Woodruff Sawyer

Medicare Set-Asides and Workers’ Compensation Claims

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Have you ever been in a workers’ compensation (WC) claim review or discussed a settlement when the claims adjuster started talking about an MSA (Medicare Set-Aside)? You may have wondered what Medicare has to do with WC. ...more

Butler Weihmuller Katz Craig LLP

New Medicare Conditional Payment Case: Federal Court Requires CMS To Perform Surgery On Its Primary Plan Reimbursement Demands

Doctors often treat Medicare beneficiaries for accident related injuries (for which a “primary” auto or workers’ compensation carrier must reimburse Medicare) and unrelated maladies at the same visit. Billing for the visit...more

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