February 2023

Our e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions.

We are looking forward to serving you in 2023 as risk management and claim settlement solutions providers.  We continue to expand and evolve our solutions to meet our client’s most challenging projects.  We thank you for trusting us with your risk and claim business needs.

Robert J. Blackburn, Managing Principal

• Are You Managing Your Total Cost of Risk?

  According to our recent survey, lowering the Total Cost of Risk (TCOR) is a primary goal of Chief Financial Officers and Risk Managers. Are you using all of the latest tools and services to gain the greatest understanding of your key drivers of risk costs? Are you obtaining a technical awareness of the key causes and conditions of your program?  Read more >>

  More Risk, Claim and Healthcare News …

  New Medicare Rule Will Recover Billions from Medicare Advantage Plans.  On January 26,2023, Medicare aid it expects to recover billions more in overpayments from Medicare Advantage plans that up coded their enrolled beneficiaries as being sicker or requiring more intense levels of care than their medical records could support.   View article...

  Recent Audits Reveal Medicare Advantage Plan Overbillings.  Kaiser Health Network (KHN) recently reported federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average.  View article...

  2023 Medicare Lien Thresholds Will Remain the Same.  Beginning January 1, 2023, the threshold for physical trauma-based liability insurance settlements will remain at $750. CMS will maintain the $750 threshold for no-fault insurance and workers’ compensation settlements, where the no-fault insurer or workers’ compensation entity does not otherwise have ongoing responsibly for medicals.  View article…

  New York State Insurance Fund Long COVID Report.   A new study from the New York State Insurance Fund revealed that almost a third of workers who filed claims for COVID-19 continued medical treatment or took time off work more than 60 days after the initial infection. View article...

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