Expanding the Long Arm of CMS

Legislation has been introduced in Congress to phase out the waiting period for Medicare over the next 10 years from 24 months to zero. Under the proposal, "......[i]n 2010, it would be reduced to 18 months and then reduced by 2 months each year until January 2019, when it would be totally eliminated."

Such an expansion would expand the involvement of CMS's roll in the workers' compensation program under the Medicare Secondary Payor Act to seek reimbursement.

Medical Bills of Smokers Reported to be Less Than Expected

It has been recently reported that smokers may actually cost society less for medical treatment than non-smokers. The CDC has reported that since smokers die on the average 10 years earlier, their medical costs are actually less to society that non-smokers.

Jordan Barab Named Acting OSHA Chief

Jordan Barab has been named Deputy Assistant Secretary for OSHA and Acting Assistant Secretary effective April 13, 2009. Barab has been an outstanding spokesperson for injured workers and was author of the well known and influential blog Confined Space. Internationally recognized as a stronger advocate for worker safety, his incredible advocacy for a safer work environment has been a hallmark of leadership. 

The AFL-CIO reported:

Peg Seminario, the AFL-CIO’s director for safety and health, says Barab is an “excellent choice” for OSHA deputy assistant secretary. 

He has decades of experience in safety and health working in the labor movement, at OSHA and in the House of Representatives on a broad range of issues. He has a deep commitment and dedication to protecting workers and will bring to OSHA the kind of energy and leadership that is sorely needed to move the agency in a new direction.

CMS Workers' Compensation Mandatory Reporting Teleconference Thursday April 9, 2009

Teleconference Event for Mandatory Reporting for
Liability Insurance (including Self-Insurance), No-Fault Insurance and Workers’ Compensation
Date: April 9, 2009
Time: 1:00 PM – 3:00 PM Eastern Time
Participation is by telephone only. (The Centers for Medicare & Medicaid Services (CMS) will not have space for individuals/entities to participate onsite at CMS).

Call-in Line: 800 779 4354
Pass Code: SECTION 111

Please begin dialing in approximately 20-30 minutes before the call due to the large number of participants.

Click here for Notice and Agenda

AIG Workers' Compensation Under Investigation Again

American International Group Inc. (AIG) is reportedly now under investigation by the insurance regulators of 50 states who are reviewing whether the company violated rate setting rules. AIG in 2006 agreed to a payment of $300 Million in a Federal law suit for mistaking premiums. The company has also been the subject to multiple Federal bailout attempts.

Candy Makers Found to Have Popcorn Lung - Flavoring Illness

It has been reported by, Andrew Schneider, investigative reporter, that severe cases of "popcorn lung" caused by exposure to diacetyl butter are now being reported in candy makers as well. Five cases of severe lung disease have been identified by physicians. Those cases involved workers who made candy.

NJ Issues a Procedural Alert for Medicare Elligible Petitioners

The New Jersey Division of Workers' Compensation has issued a procedural alert to attorneys handling claims of Medicare Elligible Petitioners. Peter J. Calderone, Director and Chief Judge of the NJ agency issued a Memorandum in an effort to establish a formalized and smooth transition with the integration of the mandatory reporting requirements to be initiated this year by The Centers for Medicare and Medicaid Services (CMS).

1. "...parties should not send unsigned settlements to CMS";

2. "...settlements signed by a judge which are not based on a transcribed court record would violate our law since judges must find a settled case resolution fair and just on the court record presented";

3. "Up to date Medicare information must be obtained prior to the entry of a signed workers' compensation order that needs final CMS approval";

4. "When a case is settled, the parties can agree on language in the settlement that a party, usually the petitioner, will be responsible for any additional CMS reimbursements. The petitioner is generally identified since only the petitioner can petition CMS for a waiver from additional payments on hardship or equity grounds. We are advised that such waivers when supported are most often granted;" and

5. "As an alternative, the parties can agree in Orders Approving Settlements (but not Section 20 Orders [lump sum payments in lieu of compensation]) and the judge can insert language in judgments that the parties have the right to reopen the case ifthere are additional Medicare reimbursements and a dispute as to which party is responsible for the payment."

The memorandum goes on to caution the parties that if the parties and the Court are uable to agree upon settlement terms, then a trial and judicial resolution will be required.