Care Bridge International strives to not only bring you the most accurate and cost-saving services, but also to keep you up to date on the most important news in our industry. 

Medicare Set Asides: You’re Paying Too Much!

Workers’ Compensation Medicare Set Asides (WCMSAs) have become a standard feature in settling workers’ compensation claims over the past fifteen years. This year, Set Aside proposals for 26,000 workers' compensation claims might be submitted to the federal government. We present new evidence that strongly suggests that this voluntary process of submission predictably and excessively inflates the cost of claims. For claims payers who are concerned about the burdens of Set Asides, this problem and its solution are top news. Read More Here! MSAs: You’re Paying Too Much

Did the 7th Circuit Allow Medicare Advantage Plans a More Powerful Right of Recovery than Traditiona

*The 7th Circuit Court of Appeals covers Indiana, Illinois and Wisconsin.* The Central District of Illinois dismissed a lawsuit brought by an Medicare Advantage Plan (MAP) against State Farm asserting double damages through a private cause of action when conditional payments had not been fully reimbursed although State Farm exhausted its no-fault policy limits. The suit, filed by MSP Recovery, LLC, a Miami, Florida based law firm that pursues claims for MAPs, was allowed by the 7th Circuit Court of Appeals to amend it’s complaint to assert a right of recovery. Simply stated, the claim would allow the MAP to assert recovery rights even after the primary plan has exhausted its policy limits

Using BIG Data to forecast Medicare Set Asides

Is it possible to forecast Medicare Set Asides using data analytics? How does an analytics approach compare to conventional methods? And what is the value proposition for making the switch? These are great questions that we will attempt to address in this article, as well as our case for the use of data analytics to forecast Medicare Set Asides. The foundation for this report begins with a journey, a quest to validate existing methods and determine if a better solution might exist that will allow primary payers to settle claims while also protecting Medicare’s interests. How did we get where we are today? That story began in 2001 when the CMS regional offices asked CMS to explain how the off

The Passing of the Baton: MSP Commercial Repayment Center Contractor Transition

Today change is in the air as Performant Recovery, Inc. prepares to take the helm as the new MSP Commercial Repayment Center Contractor with CMS. Town Hall presentations were held via webinar on January 17 for Group Health Plans (GHP), and January 18 for the Non-Group Health Plans (NGHP). Per Ted Doyle, MSP CRC Project Director, Performant’s main goal as the incoming CRC is to provide a smooth and seamless transition and emphasized CMS processes would remain unchanged. If you were not able to attend the call, slide decks from both presentations will be available sometime next week on CMS.gov website, CB&R page, click on the What’s New tab. CMS processes can be complicated and knowing what to

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