OWENS CORNING'S ASBESTOS LIABILITIES SET AT $7 BILLION BY FEDERAL JUDGE
OC's asbestos liability put at $7 billion by U.S. Judge. Choosing a midpoint between estimates of opposing creditor groups, a federal judge has ruled that Owens Corning is exposed to $7 billion in potential claims by people who were made sick by exposure to asbestos insulation produced by the firm until the early 1970s. 

W.R. Grace and Executives, in Asbestos Concealment Action. Charged With Fraud, Obstruction of Justice, and Endangering Libby Montana Community 

New Report Reveals That Medicare is Covering $23 Billion in Medical Costs That Should be Paid by Workers' Compensation --$4.2 Billion Halliburton Asbestos Settlement Given Final Approval by Court -- Recent Court Decisions: Dinner Not A Deviation from Employment (NJ Supreme Court) -- Remicade linked to severe hepatic reactions, including acute liver failure, jaundice, hepatitis and cholestasis. -- 2nd Annual This Year in Workers' Compensation - The Top Issues and Cases - March 8, 2005 -- Medicare Secondary Payer Act - Waivers and Compromises CMS -- Social Security Announces 2.7 Percent Benefit Increase for 2005 Monthly Social Security and Supplemental -- FDA Statement on the Halting of a Clinical Trial of the Cox-2 Inhibitor Celebrex  

Beneficiary Automated Status and Inquiry System -The Beneficiary Automated Status and Inquiry System (BASIS) is available to participants of the Voluntary Data Sharing Agreement (VDSA) program. The BASIS allows you to make on-line Medicare entitlement queries to CMS’ Enrollment Data Base (EDB) to determine if an individual is a Medicare beneficiary and if so, obtain available entitlement information. The BASIS serves as a useful tool when you have a need to know specific information during the interval between quarterly file exchanges.

 Recent decisions posted to our web site:  -CMS MEDICARE SECONDARY PAYER ACT: ALLEGED OVERPAYMENT COULD NOT BE WAIVED -EXCLUSIVITY BAR -S...

 GOA concluded in a recent report that Medicare's system for recovering MSP debt from EGHP's is no longer cost-effective. CMS presentl;y is recovering only 38 cents for every dollar it spent on recovering activities in fiscal-year 2003. A major finding was that contractiors were funded at a rate that exceed their workload. The report also found that CMS failed to trnsmit cases to contractors and that inhibited recovery. CMS plans to launch a new recovery system that has been undevelopment for the last 6 years to increase the efficiency of its recovery operations.

Vioxx Recalled Worldwide--How to Apply for a Handicapped Placard--Ford Door Latch Personal Litigation--CMS Assist(tm) - New Support Group for Professionals--Gelman to Speak at NOSSCR on Medicare

 Interest is calculated from the date of the final determination and is owed if the amount of the overpayment or underpayment is not paid within 30 days. Interest accrues daily but is assessed and calculated in 30-day periods. A period that is less than 30 days is considered to be a full 30-day period.

TWO FINANCIAL TITANS AVOID CARING FOR INJURED WORKER Injured woman spends her retirement funds, still can't get care. A claimant has been waiting and waiting for temporary disability benefits or medical treatment for over a year. 

CMS ANNOUNCES IMPLEMENTATION OF BENEFICIARY ACCESS SYSTEM. The Beneficiary Automated Status and Inquiry System (BASIS) is available to participants of the Voluntary Data Sharing Agreement (VDSA) program. The BASIS allows you to make on-line Medicare entitlement queries to CMS’ Enrollment Data Base (EDB) to determine if an individual is a Medicare beneficiary and if so, obtain available entitlement information. The BASIS serves as a useful tool when you have a need to know specific information during the interval between quarterly file exchanges. 

CMS issued a memorandum on prohibiting costs to be chargeable against Medicare set-aside arrangement funds.The purpose of this All Regional Administrators memorandum is to replace the policy that was outlined in the answers to questions in the All Associate Regional Administrators (ARA) memorandum concerning Workers’ Compensation Commutation of Future Benefits (issued on July 23, 2001, attached) and in the answer to question seven from the April 21, 2003 Frequently Asked Questions (FAQ).

 Medicare Expands Drugs Available Under Program to Help Beneficiaries with Severe Illnesses - A New CMS/MSP Issue for Reimbursement? For these...

 MEDICAL GUIDELINES IN WC CASES APPROVED BY TEXAS SP CT. "In this opinion, we conclude that the Legislature authorized TWCC to set upper limits on reimbursement amounts and establish a reasonable time limitation on requests for medical dispute resolution. TWCC acted consistently with the Legislature’s mandates - (1) the establishment of fair and reasonable guidelines designed to ensure quality medical care for injured workers, TEX. LAB. CODE § 413.011(b), (2) the achievement of effective medical cost control in the workers’ compensation system, id., and (3) the establishment of a program for resolution of disputes regarding health care treatments and services, id. § 413.013(1). "

CMS: NJ ADOPTS A SIGN OF THE TIMES. The NJ Division of Workers' Compensation has created a new hearing list designation..."Pending Medicare Approval.” It can be assumed that these cases are matters that the parties have voluntarily noticed the Court of the existence of potential Medicare interests. Rumor has it that between 25,000 and 40,000 cases on the NJ docket alone are subject to CMS (Centers for Medicare and Medicaid Service) review. The number of cases being given that designation will obviously grow epidemically in the near future to include ALL cases involving: beneficiaries presently on SSA disability OR potential beneficiaries, ie. 62.5 yrs and those who may seek benefits in the near future. Probably all SIF (Second Injury Fund) matters will be subject that designation universally. The number of cases may far exceed those where the State is already data-matching: ie. TDB liens, matrimonial liens and child support liens. 

 At a recent meeting in Atlanta GA, CMS (Centers for Medicare and Medicaid Service) announced State Workers’ Compensation Data Exchanges. 

 The Health Insurance Portability and Accountability Act includes a provision establishing the Medicare Integrity Program (MIP). This provision gives the Centers for Medicare & Medicaid Services (CMS) authority to enter into contracts with entities to promote the integrity of the Medicare program. The MIP includes a range of Medicare program areas such as cost report auditing, medical review, anti-fraud activities, and the Medicare Secondary Payer (MSP) program. 

 Payments of Medicare and Medicad are continuing to grow at a rate faster than the nominal gross domestic product. By 20111national health costs will constitute 17% of the GDP, up from the 200 level of 3.2% and will total $2.8 trillion. The Center for Medicare and Medicare Services are actively reviewing payments that should have been made under Workers' Compensation programs and co-ordinating benenfits through a vast network of benefit coordinators and a growing effort of investigation, reporting and enforcement activities.

 The Secondary Claim Development (SCD) Questionnaire is a Medicare Secondary Payer (MSP) questionnaire that is sent to obtain information about other insurers that may pay before Medicare. The SCD is mailed when a claim is submitted to Medicare with an explanation of benefits (EOB) attached, a self-report is made by you or your attorney identifying an MSP situation, or a third party payer submits MSP information to a contractor, or the Coordination of Benefits (COB) Contractor. 

 MEDICAL GUIDELINES IN WC CASES APPROVED BY TEXAS SP CT--"In this opinion, we conclude that the Legislature authorized TWCC to set upper limits on reimbursement amounts and establish a reasonable time limitation on requests for medical dispute resolution

CMS/MSP New Address --  New Address for Receipt of Workers’ Compensation Medicare Set-aside Arrangement (WCMSA) Proposals (and all subsequently requested documents) for the Centers for Medicare & Medicaid Services (CMS) Review.