Category Archives: WCMSA

Blog, Medicare Set Aside, WCMSA

The worker’s compensation system has been notorious for settlement of a “denied claim.” These are the claims where the cost to litigate the matter is greater than the settlement options. Thus, in exchange for a sum of money the Claimant agrees to discontinue their application for WC benefits. Over the years we have witnessed the Centers for Medicare and Medicaid …
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Medicare Reporting Section 111, ORM, WCMSA

Katie A. Fox, MSCC – October 21, 2011 The much awaited Version 3.2 of the User Guide was released on August, 17, 2011. The User Guide outlines several changes, but hidden in section 11.8 is a process to manually terminate the ORM status between Section 111 claim detail electronic submissions.  Throughout the industry the subsequent memorandums have gained much publicity, …
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Medicare Set Aside Protocol in the WDNY

06 May 2011 Jeff Signor No Comments

Blog, Medicare Reporting Section 111, Medicare Set Aside, WCMSA

Today I had the honor of presenting on the topic of Medicare Secondary Payor Compliance with Robert Trusiak, Esq, Assistant US Attorney for the Western District of New York.  We presented at the headquarters of the Erie County Bar Association, and the presentation was sponsored by the Western New York Chapter of the Women’s Bar Association.  The protocol is set …
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Blog, Medicare Set Aside, WCMSA

By Alvena Ferreira, RN, CCM, CNLCP, MSCC and Katie A. Fox, MSCC Effective December 1, 2010, the New York State Worker’s Compensation Board will implement medical treatment guidelines for injuries to the neck, mid and low back, shoulder, and knee. The guideline documents state that these were developed in part from the State of Colorado’s guidelines and ACOEM guidelines. The …
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Blog, Medicare Set Aside, WCMSA

By Alvena Ferreira, RN, CCM, CNLCP, MSCC and Katie A. Fox, MSCC On November 5, 2010 the FDA approved Cymbalta (duloxetine hydrochloride), an antidepressant, to treat chronic back pain as well as osteoarthritis. The dosage that can be prescribed is 60 mg/day.  Previously, Cymbalta was only authorized for the treatment of diabetic peripheral neuropathy, generalized anxiety disorder, and fibromyalgia.  The expansion …
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