Understanding Public Income and Medical Benefits after the Affordable Care Act

There’s a lot more to the Affordable Care Act than buying private health insurance through an exchange marketplace like www.CoveredCA.com. Four kinds of public benefits can help people get the medical care they need: Subsidized premiums and co-pays for private health insurance purchased through an exchange.  Commercial insurers issue these policies, not the government. Medicare, […]

The Elephant in the Room

Sometimes the issues the lawyers and adjusters are discussing are not what is most important to the Applicant. Recently, in a pretty small case, the professionals told me the disagreements were about what had been paid and what was still due. The injured worker told me his biggest concern was that, although he had returned […]

DON’T LET POLITICS GET IN THE WAY

“AFFORDABLE CARE ACT” NOT “OBAMACARE” The term “Obamacare” is a nickname for the Affordable Care Act.  But sometimes politics can get in the way of clear thinking.   The Affordable Care Act encompasses much more than the purchase of private health insurance on an exchange like Covered California, www.CoveredCA.com. When discussing settlement with counsel and clients, […]

How Mediation Saves Time, Money and Stress

How Mediation Saves Time, Money and Stress Mediation of Workers Compensation claims is commonplace in some states and mandatory in some. Elsewhere, such as in California, claims professionals and attorneys are still starting to catch on to the benefits of mediation. Multiple Appearances With Judge Can Accomplish Little Budget cutbacks and increasing caseloads mean less […]

FOUR REASONS TO AVOID THE CMS APPROVAL PROCESS FOR MSAs

Many Workers Compensation professionals believe they must secure approval of a Medicare Set-Aside (“MSA”) before they can close out medical benefits.  In California terms, professionals think they cannot complete a full Compromise & Release (C&R) without going through a lengthy administrative process.  This is not true. 1)                   MMSEA reporting makes approval unnecessary for Medicare beneficiaries.  […]