Tower News

Stay up to date on Tower MSA Partners news and events

The Penalties are Coming

Posted on April 6, 2020 by Tower MSA Partners

The Penalties Are Coming

With COVID-19, it’s understandable if Civil Monetary Penalties (CMPs) have slipped your mind.  CMS has proposed stiff penalties—up to $1,000 per day per claimant—for incorrect MSP reporting or failure to report. (Our Chief Compliance Officer Dan Anders posted on these in February.) For a well-written synopsis of how they could affect you, read this article by Michael Stack, CEO of AMAXX, LLC: Increased Penalties are Coming for Incorrect Medicare Secondary Payer Reporting.

CMS’s Revised Consent to Release Form Becomes Mandatory April 1

Posted on March 18, 2020 by Tower MSA Partners

As of April 1, 2020, submissions of Workers’ Compensation Medicare Set-Asides (WCMSAs) must include CMS’s revised Consent to Release form.  The form indicates that the need and process for the WCMSA have been explained to the injured worker, and that the injured worker has approved the contents of the submission, including the allocated funds.

First announced with the release of an updated WCMSA Reference Guide on October 10, 2019 (Version 3.0), the revised consent must include the following language:

Further, I have had the Workers’ Compensation Medicare Set-Aside Arrangement need and process explained to me, and I approve of the contents of the submission.

Beneficiary Initials: ____

A copy of the revised consent can be found here.

Practical Implications

If the claimant is represented by an attorney, the attorney will typically explain why an MSA is needed in settlement of their WC case.  If not represented, this responsibility may fall to the adjuster or defense attorney.

CMS provides resources to assist with the MSA explanation in both the WCMSA Reference Guide and the Self-Administration Toolkit.  Additionally, for professionally administered MSAs, our partner Ametros provides general information as well as individual consultation to walk the injured worker through how the MSA will work post-settlement.

As mentioned above, the revised consent requires the claimant to approve the contents of the MSA submission.  While a review of the MSA report alone by the claimant or their attorney may be enough to obtain the beneficiary’s approval, if the injured worker requires additional documentation prior to their approval, Tower will provide it.

Finally, keep in mind, consent without the revised Consent to Release language will no longer be valid as of April 1.  Consequently, Tower may provide a revised consent form to be executed by the claimant prior to submission or resubmission of the MSA to CMS.

If you have any questions please contact Tower’s Chief Compliance Officer, Dan Anders, at (888) 331-4941 or daniel.anders@towermsa.com.

Meloxicam’s Price Drop – Good News for MSAs

Posted on March 16, 2020 by Tower MSA Partners

Our Chief Compliance Officer Dan Anders’ blog post on the huge price drop of Meloxicam prompted a WorkCompCentral article, quoting Dan.  Previously priced at $4.25 per pill for 15 milligrams, it’s now 5 cents per pill.  Over a 20-year life expectancy of an injured worker taking 15 milligrams a day, the old price meant an MSA allocation of $30,000. With the reduced price, that allocation would be $300.  For details, see http://bit.ly/2IHjYwn (subscription required).

Tower’s Dan Anders Comments on NY Ban on Hold-Harmless Clauses in Settlement Agreements

Posted on March 6, 2020 by Tower MSA Partners

New York Workers’ Compensation Board recently issued a bulletin indicating it will not approve settlements requiring injured workers to indemnify or hold insurers harmless if Medicare demands future reimbursements. Tower’s Chief Compliance Officer Dan Anders said the board may be responding to a growing trend of MSAs and settlements that are not submitted to Medicare for review. See WorkCompCentral’s coverage here (subscription required)

Cybersecurity Webinar Garners More Coverage

Posted on March 6, 2020 by Tower MSA Partners

Cybersecurity is a hot topic and a major threat to all businesses and organizations – especially those handling personal health data.  Risk & Insurance’s Courtney DuChene covers the threat in detail, including data from Tower MSA Partners’ cybersecurity webinar and a separate webinar featuring Safety National’s Mark Walls.  Read it here: hipaa violations are just one of the exposures in a workers comp industry cyber attack

Business Insurance: Insurers could face stiff MSP penalties

Posted on March 3, 2020 by Tower MSA Partners

Business Insurance’s Angela Childers examined CMS’s proposed rules for Section 111 Mandatory Insurer Reporting penalties in this Feb. 26 article.  She quoted Tower’s Chief Compliance Officer Dan Anders on the severity of the possible $1,000 per-day-per-claim penalty for not reporting MSP data or not reporting it with sufficient accuracy. You don’t want to face a $365,000 or more penalty. See Dan’s post for proposal details and contact him at Daniel.anders@towermsa.com for direction on how to submit comments and prepare for the impending penalties.

Cybersecurity Threats & You

Posted on March 3, 2020 by Tower MSA Partners

Many businesses don’t think a data breach will happen to them; small businesses especially assume they’re too small to attack. However, Tower’s Feb. 19 cybersecurity webinar featured a survey that showed that 11% of very small businesses and 44% of midsized organizations experienced a data breach in the last 12 months.  A quarter of these companies had to file for bankruptcy, 10% went out of business entirely. See Nancy Grover’s excellent coverage of the webinar for workerscompensation.com.  And, you can watch the webinar at Tower’s webinar.

Tower to Speak at WCI

Posted on February 17, 2020 by Tower MSA Partners

WCI notified Tower MSA Partners that our proposal on Managing CAT Claims was accepted for the National Trends track at the 2020 conference (August 16-19).  The session will present strategies for managing and settling complicated, high-cost catastrophic claims.  Using case studies, a panel of experts examine key decisions that led to positive outcomes. While not all catastrophic claims settle, with the right strategies, resources and partners, many that haven’t, could. Plan to attend! #WCI2020.

Tower’s Dan Anders is New NAMSAP VP

Posted on February 7, 2020 by Tower MSA Partners

The National Alliance of Medicare Set-Aside Professionals (NAMSAP) has announced its 2020 Board of Directors, including our Chief Compliance Officer Dan Anders, who was elected by the board as Vice President. Dan will work closely with NAMSAP President Ciara Koba of Gordon Rees and other board members to continue their effective dialog with CMS on a range of MSP compliance matters.  In addition to serving as Vice President, Dan is co-chair of the Policy & Legislative Committee which reviews and provides recommendations to the board concerning proposed MSP legislation and CMS policy.

For details, see the article in WorkCompWire.

New Guide to Medical Treatment After Settlement

Posted on December 13, 2019 by Tower MSA Partners

The Tennessee Bureau of Worker’ Compensation recently published the “30-Minute Guide to Medical Treatment after Settlement.”  Tower’s Chief Compliance Officer Dan Anders was a significant contributor to the guide, along with Ametros’ Dorothy Holland and Humana’s Brian Bargender, CRSP. 

An educational resource for the state’s injured workers who are deciding whether to settle the medical portion of workers’ compensation claims, the guide covers: 

  • Lifetime medical benefits vs. closed medical benefits
  • How future medical costs are calculated
  • Settlement negotiations
  • Workers’ Compensation Medicare Set-Asides (WCMSAs)
  • Self-Administration vs. Professional Administration of post-settlement medical funds

Designed to help injured workers better understand open lifetime medical benefits and the consequences of closing their workers’ compensation claims, the guide helps injured workers carefully consider their options and make informed decisions. The 19-page PDF is available at https://www.tn.gov/content/dam/tn/workforce/documents/injuries/30MinuteGuidetoMedicalTreatmentafterSettlement.pdf

For Media Inquires, Contact:

Helen King Patterson
813.690.4787
helen@kingknight.com

    Subscribe to our blog & news

    Search our blog:

    Contact Us for a FREE Consultation