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Why is it called a "Section 20" settlement? A. The settlement is a creature of statute, N.J.S.A. 34:15-20. In New Jersey's statutory system, Title 34 is "Labor and Workmen's Compensation," Chapter 15 is "Workmen's Compensation," and Section 20 details the settlement process. Q. When does a Section 20 settlement come into play?
An MSA is a determination of post-settlement Medicare-covered healthcare needs associated with the workers’ compensation injury and is in place to prevent a cost-shift to the Medicare program. Post-settlement, CMS coordinates benefits with MSAs by flagging a Medicare beneficiary’s Common Working File (“CWF”) with an MSA marker denoted ...
Shawn.Deane@j29inc.com. (866) 529-6771. www.j29inc.com. As General Counsel & Vice President of Claims Solutions, Shawn Deane leads J29’s legal and Medicare Secondary Payer (MSP) services team. Shawn is a practicing attorney and has over 16 years of experience in Medicare compliance, workers’ compensation, and insurance claims.
The January 2022 addition of Section 4.3 to the CMS WCMSA Reference Guide that discussed the agency’s treatment of non-submit Medicare Set-Asides caused quite a stir throughout the MSA industry and raised many questions for those who use non-submit MSAs in workers’ comp settlements. A February CMS webinar addressed some of those questions and we now have an update | WorkersCompensation.com
Shawn.Deane@j29inc.com. (866) 529-6771. www.j29inc.com. As General Counsel & Vice President of Claims Solutions, Shawn Deane leads J29’s legal and Medicare Secondary Payer (MSP) services team. Shawn is a practicing attorney and has over 16 years of experience in Medicare compliance, workers’ compensation, and insurance claims.
This new decision has turned Nevada workers’ compensation subrogation on its ear, and transformed Nevada into one of the most favorable states in which to pursue workers’ compensation subrogation claims. It is hard to believe, but Nevada was actually one of the first states to enact workers’ compensation laws—back in 1913.
Section 32 Waivers. In a bulletin released last week, the NYS Workers' Compensation Board announced that it would begin utilizing a desk review process, as opposed to a formal hearing, to review Section 32 waiver agreements involving claimants who are represented by counsel so long as the gross settlement amount is $10,000 or less.
Hattiesburg, MS (WorkersCompensation.com) -- When litigation overlaps with a workers' compensation claim, what rights do employers, carriers, and TPAs have when a worker settles her case. In Brent v. Mississippi Department of Human Services, No. 2022-CT-00529-SCT (05/30/24), the highest court in Mississippi held that a worker didn't have to pay $2,887.50 out of a settlement ...
Shawn.Deane@j29inc.com. On November 13, 2023, the Centers for Medicare & Medicaid Services (CMS) held a webinar on anticipated changes with respect to the potential inclusion of certain workers’ compensation Medicare Set Aside (MSA) information in relation to Sec. 111 reporting. CMS representatives referred to this session as “an early ...
By Kimberly Wiswell, Director of Client Services, Embedded AI, Gradient AI Medicare Set-Aside Arrangements (MSAs) are an important part of workers’ compensation programs and assist in earmarking settlement funds to cover future medical expenses stemming from workplace injury claims. However, providing an easy process for adjusters to refer MSAs, as well as managing operations to ...