NC Industrial Commission Unveiling New Integrated Case Management System
NC Industrial Commission Unveiling New Integrated Case Management System
Alerts
The Centers for Medicare and Medicaid Services (CMS) Confirms Civil Monetary Penalty (CMP) Rules Regarding Mandatory Insurer Reporting for Non-Group Health Plans (NGHP)
CMS held a webinar on January 18, 2024, where it provided clarification of the rules regarding the issuance of CMPs for late Section 111 reporting of the ongoing responsibility for medicals (ORM) and total payment obligations to a claimant (TPOC). The PowerPoint presentation should be posted on CMS’ website in two weeks. In sum, the […]
CMS to Demand Section 111 Reporting of Funds Set Aside for Future Medicals in Workers’ Compensation Settlements
By Shannon Metcalf The Centers for Medicare and Medicaid Services (CMS) is expanding the existing Section 111 reporting process to capture information on all workers’ compensation claims involving Medicare beneficiaries that receive a settlement (i.e., TPOC) and funding for a Workers’ Compensation Medicare Set-Aside (WCMSA), regardless of whether the workers’ compensation settlement was reported to […]
CMS Increasing Threshold for Liability Settlements – Fixed Percentage Option
The Fixed Percentage Option Threshold will Increase to $10,000.00 for Liability Settlements on October 2, 2023 says The Centers for Medicare & Medicaid Services (CMS) By Shannon Metcalf Since November 7, 2011, the Centers for Medicare and Medicaid Services (CMS) has permitted a Medicare beneficiary to elect to resolve his/her conditional payment claim in liability […]
NC Legislature Clarifies ‘Extended Benefits’ Law
North Carolina’s Workers’ Comp Act, specifically N.C. Gen. Stat. 97-29(c), has a 500 week “cap” on entitlement to temporary total disability (TTD) benefits. The statute also provides an employee with the opportunity to apply for extended TTD benefits beyond 500 weeks, upon a showing that the employee has suffered from a “total loss of wage-earning […]
COA Issues Opinion On Extended Benefits
The Court of Appeals Issues Its First Opinion on Extended Benefits By Duane Jones The Court of Appeals has issued its first opinion on extended disability benefits, which came into being following the 2011 amendments to N.C.G.S. § 97-29(c). In Sturdivant v. N.C. Dept. of Public Safety, COA22-421 (April 18, 2023), the Court held that […]
A Second Bite at the WCMSA Apple?
The Centers for Medicare & Medicaid Services (CMS) Removes Maximum Time Limit to use Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Amended Review Process By Shannon Metcalf Do you have cases that you cannot settle due to an outdated, CMS-approved WCMSA? If so, there is good news as CMS has changed the Amended Review process to […]
Recent Opinions at the Deputy Commissioner Level on COVID Claims
By Brooke A. Mulenex The Industrial Commission has issued two Opinions at the Deputy Commissioner level on COVID claims. Both claims involve pro-se claimants and there was no expert testimony; both claims were denied and no benefits were awarded. While both were in Defendant’s favor, the true value of these decisions is debatable given the […]
AB5: A New Standard for Worker Classification – Part 4
by Joe D. Delfino In several of our most recent articles, we discussed the potential impact of AB5 (California Labor Code § 2775); a law passed in California which went into effect on January 1, 2020 and addressed the classification of certain workers as either employees or independent contractors. Since the passage of AB5, there […]
DOT/FMCSA Noteworthy Updates (Spring 2022)
Allen C. Smith, Austin R. Walsh On 3/1/22, the Department of Labor (DOL) announced a partnership with the American Trucking Association (ATA) to participate in the Biden Administration’s 90-day Trucking Apprenticeship Challenge, which is a part of the Administration’s Trucking Action Plan (TAP). To date, over 100 employers have accepted the Challenge that has resulted […]