CMS Releases Updated Guidance for Workers’ Compensation Medicare Set-Aside Reporting and Reviews
On April 1, 2024, the Centers for Medicare and Medicaid Services (CMS) released new detailed guidance for reporting workers’ compensation settlements involving individuals who are Medicare eligible. See NGHP User Guide | CMS. As part of a series of new detailed guidance, CMS provided specifics with respect to the information required by CMS when a workers’ compensation settlement is submitted for [...]
GAO Reports $44 billion in UI improper payments in 2023: New UI Improper Payment Methodology Needed
On March 26, 2024,the Government Accountability Office (GAO) released its improper payment report with an estimate of $44 billion in improper payments in the Unemployment Insurance program for 2023. The US Department of Labor reported a combined improper and unknown payment rate of 22.2 percent for the Unemployment Insurance program in fiscal year 2022, which exceeded the 10 percent threshold [...]
Bi-Partisan COMP Act (HR 7368) Gains Support from Business and Worker Representatives
On Friday, March 15th business and worker representatives joined in support of the Comp Act (HR 7368) introduced by Congressmen Mike Carey (R-OH) and Mike Thompson (D-CA). The letter (attached) notes that HR 7368 would: Create certainty for calculating the amounts to be included in Workers’ Compensation set-asides. Provide appeal rights from reviews by the Centers for Medicare and Medicaid Services. [...]
President Biden’s Proposed FY 2025 Budget Would Increase Integrity Funding While Addressing Reemployment and Equity
President Biden has released the proposed Fiscal Year 2025 Budget. See Budget of the United States Government, Fiscal Year 2025 (whitehouse.gov) The Budget narrative provides for increases in funding for integrity measures, continued focus on reemployment and equity. The budget describes the UI related initiatives in the proposal below. Modernizes, Protects, and Strengthens UI. The UI program provides a critical safety net [...]
CMS Expands Workers’ Compensation Reporting Requirements with No New Statutory or Regulatory Authority
On February 23, 2024 the Centers for Medicare and Medicaid Services (CMS) released an alert seeking to expand the Section 111 reporting requirements for Non Group Health Plans (NGHPs) See MMSEA S111 GHP Alert (cms.gov). The expansion goes well beyond the general statutory requirement in 42 U.S.C. 1395y(b)(7)&(b)(8), and would impact self-insured employers, workers’ compensation plans, and injured workers with [...]
Coalition Applauds Bi-Partisan Legislation To Improve Administration of Medicare With Workers’ Compensation
Legislation supported by UWC and a coalition of stakeholders in workers’ compensation has been introduced to address the need for clarification when there are workers’ compensation settlements involving employees who are also Medicare eligible. The appropriate determination of amounts to be paid under the applicable workers’ compensation law and Medicare has been an issue for many years without specific legislative [...]