Friday, October 28, 2016

Presidential Election and Medicare

With the Presidential Elections on November 8th nearing around the corner, the industry has been wondering how the election of either Hillary Clinton or Donald Trump as President of the United States would affect Medicare Secondary Payer (MSP) Act compliance. *Note that this blogwire article is not intended to be an endorsement for either political candidate, political party, platform, or affiliation.
If Donald Trump is elected: Donald Trump’s website does not directly address his position on Medicare. However, according to a Forbes.com article, “The GOP platform advocates a “premium support model” for Medicare that would “guarantee to every enrollee an income-adjusted contribution toward a plan of their choice, with catastrophic protection.” In other words, privatization. Republicans would “save Medicare by modernizing it,” the platform says.”
                Potential Impact: Currently 31% of Medicare beneficiaries are enrolled in a private Medicare Advantage Plan (MAP). That percentage is expected to increase, and if Trump is elected, we may see that number rise more rapidly. The effect on MSP would be that we would see a rise in conditional payments being made by MAPs, versus traditional Medicare.
Over the past several years, we have seen increased case law finding that Medicare Advantage plans have the same rights as Medicare to recovery, thereby allowing the Medicare Advantage Plan to assert double damages. As Medicare Advantage Plans have become even more aggressive with lawsuits for double damages than traditional Medicare has, we could expect that to continue. Primary payers would be wise to enact a proactive solution to ensure that Medicare Advantage Plan conditional payments are addressed, particularly in those Circuits where the Courts have found in favor of MAPs having these rights.
                To learn more about MAPs and recommendations to address reimbursement of these payments, please join Franco Signor for a webinar wherein we will feature a special guest to discuss these Best Practices on November 18th, at 1:30 PM. Registration for the webinar can be found here.
If Hillary Clinton is elected: According to Hillary Clinton’s website, Hillary Clinton proposes to allow people 55 and older to buy into Medicare. She is calling this “Medicare for More.” Additionally, Clinton rejects the idea of gradually converting Medicare into a privatized system.
                Potential Impact: Currently, the age to enroll into Medicare is 65. If people aged 55 and up could now buy into Medicare, there ideally will be more MSP claims to address as the Medicare population would expand to a younger age group.
Summary: While neither candidate can single-handedly make these changes and would need the support of Congress, with either candidate we are likely to see an increase in claims that would require MSP compliance. Whether we continue to see Medicare beneficiaries move to private Medicare Advantage Plans which continue to press for their rights to double damages reimbursement, or the Medicare pool expands to individuals 55 and up, MSP compliance will be more important than ever.
Additionally, CMS has indicated that an award for the Workers’ Compensation Review Contractor (WCRC) will take place in the second quarter of next year. With the new WCRC, we may also have thresholds for Liability Medicare Set-Aside (LMSA) review. 2017 will be an interesting year, and having a strategic partner that is ready to provide a holistic claims strategy to your MSP compliance program will be vital.
Contact Neil O'Toole and John Sbarbaro
Phone: 303-595-4777
Located in the Denver Metro area.
226 West 12th Avenue Denver, Colorado 80204

Disclaimer 


Any content of this blog is intended for informational purposes only.It is not intended to solicit business, provide legal advice from The Law Office of O'Toole & Sbarbaro, P.C. and does not serve as a medium for an attorney-client relationship. Therefore, The Law Office of O'Toole & Sbarbaro, P.C. is not responsible for the information on this blog which may not apply to every reader. Always seek professional counsel if you have any legal matters. Contents within the blog of The Law Office of O'Toole & Sbarbaro, P.C., logos and other related media are protected by the copyright laws of the United States and other jurisdictions.


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Wednesday, October 19, 2016

Rate drop of Recordable Workplace Injuries

Asst Sec of Labor Encouraged by BLS Report on Occ Injuries & Illnesses in 2015

Washington, DC – Occupational injury and illness data recently released by the Bureau of Labor Statistics showed a significant drop in the rate of recordable workplace injuries and illnesses in 2015, continuing a pattern of decline that, apart from 2012, has occurred annually for the last 13 years.
Private industry employers reported about 2.9 million nonfatal workplace injuries and illnesses in 2015, representing a decline of about 48,000 from 2014, despite an increase in total hours worked. The rate of cases recorded was 3.0 cases per 100 full-time workers – down from 3.2 in 2014. The rate is the lowest recorded since at least 2002, when OSHA recordkeeping requirements were modified.
Assistant Secretary of Labor for Occupational Safety and Health issued the following statement:
“We are encouraged to see the significant decline in worker injury and illness rates. This is the result of the relentless efforts of employers, unions, worker advocates, occupational safety and health professionals, and federal and state government agencies ensuring that worker safety and health remains a top priority every day.”
“Despite the decline, approximately 2.9 million private sector workers suffered nonfatal injuries and illnesses last year. That is still far too many. At OSHA, we will continue to do all that we can to continue driving the rate down.”
Click here to view: BLS Report on Occupational Injuries and Illnesses in 2015 (PDF)
Source: OSHA

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Contact 
Neil O'Toole and John Sbarbaro
Phone: 303-595-4777
Located in the Denver Metro area.
226 West 12th Avenue Denver, Colorado 80204

Disclaimer 

Any content of this blog is intended for informational purposes only.It is not intended to solicit business, provide legal advice from The Law Office of O'Toole & Sbarbaro, P.C. and does not serve as a medium for an attorney-client relationship. Therefore, The Law Office of O'Toole & Sbarbaro, P.C. is not responsible for the information on this blog which may not apply to every reader. Always seek professional counsel if you have any legal matters. Contents within the blog of The Law Office of O'Toole & Sbarbaro, P.C., logos and other related media are protected by the copyright laws of the United States and other jurisdictions.


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