MSA Vendor or MSP Counsel: Choosing the Right Medicare Compliance Strategy
Traditional MSA vendors and MSP counsel may address the same Medicare exposure, but they do not approach the claim the same way. This article examines where the models differ, when each makes sense, and why complex claims often benefit from a counsel-led strategy that connects legal responsibility, medical exposure, settlement planning, and reporting.
CMS 2025 MSA Data Revealed: What It Means for Your Workers’ Comp Program
CMS’s 2025 MSA report reveals notable shifts in workers’ compensation settlements—fewer reviews, larger claims, and a widening gap between proposed and approved amounts. Add in the end of CMS-approved zero-dollar MSAs and expanded Section 111 reporting, and the compliance landscape looks very different. Discover what these trends mean for risk managers, adjusters, employers, and attorneys, and how to stay ahead in 2026.
CO DWCEC 2026: The Next Frontier in Workers’ Comp Is Not Just Innovation. It Is Execution.
Four innovators. Four very different ideas. One shared truth. Workers’ comp still slows down in the same places it always has. Communication, treatment, and information flow. The next breakthrough won’t come from something new. It will come from getting these right.
Hidden Dangers in Section 111 Reporting: Avoiding Errors That Balloon Claim Costs and Reserves
Most Section 111 reporting issues don’t show up until it’s too late. What looks clean on the surface can hide data gaps, timing mistakes, and mismatched reporting that trigger real exposure. With enforcement tightening, those misses are getting more expensive and harder to unwind. This breaks down where programs actually slip, what’s being overlooked, and how to catch it before it turns into a problem.
PARMA 2026: Budget Pressure Is Reshaping Risk Management for Public Agencies
Public agencies are being asked to deliver more services, manage growing risk, and do it all with tighter budgets. At the 2026 PARMA Conference, one session tackled this reality head-on, exploring how funding gaps, workforce strain, and rising insurance costs are reshaping risk management for municipalities. The discussion revealed a critical shift: budgeting, operations, and risk strategy can no longer be treated as separate conversations.
How to Audit Your Mandatory Insurer Reporting Program Before Civil Money Penalties Hit
Mandatory insurer reporting used to be a back‑office chore. Now, with CMS poised to begin random Section 111 audits as early as January 2026 and civil money penalties edging toward $1,500 a day, late reporting has become a board‑level risk. Employers, carriers and TPAs must rethink MIR as enterprise risk management: verify who is actually responsible for reporting, audit data across workers’ comp and liability lines, understand the new Medicare Set‑Aside reporting requirement, and use the safe‑harbour process when information is missing. The good news is that independent legal audits can now review accident dates, ICD codes and settlement amounts and provide defensible opinions on what should be reported. In this post, founder Carlos Luna shares practical steps to audit your MIR program before CMS or a plaintiff’s attorney does—and explains how partnering with experienced counsel can turn compliance into a competitive advantage.
When Modified Duty Isn’t Available, You Are Bleeding Money
When modified duty isn’t available, time becomes the biggest cost driver in a claim. Files stall. Temporary disability continues. Indemnity exposure quietly grows. For employers without reliable modified duty capacity, “no option available” can quickly turn into prolonged duration and financial unpredictability.
In this new blog, we break down real-world outcomes from 53 de-identified claims (January–November 2025) and show how structured Alternative Return to Work creates speed, engagement, and measurable indemnity impact. The case study demonstrates how forward movement reduces drift, strengthens file narratives, and helps employers regain control when internal accommodations aren’t possible.
Compounds in Workers’ Comp: The Ghost of the 90s, the Reality of Today, and Why We’re Still Arguing
Revisiting compound medications in workers’ comp—what changed, what didn’t, and how disciplined use can support recovery and better claims outcomes.
Four Areas Where Technology Is Creating Real Value in Workers’ Compensation Claims
Workers’ compensation carriers and TPAs are under growing pressure to manage rising medical costs, litigation risk, and claim complexity. This article examines four areas where claims technology is driving measurable value today — early claim triage, medical management, billing integrity, and litigation readiness — while outlining the guardrails payers must have in place to remain compliant, defensible, and operationally sound.
The MSP Landscape: What Every Claims Department Must Prepare For in 2026
In 2026, Medicare Secondary Payer (MSP) compliance is no longer sitting quietly in the background of claims operations. It is front and center—shaping how claims are handled, how settlements are structured, and how risk is managed across organizations. For claims adjusters, claims leaders, risk managers, employers, carriers, and attorneys, the reality is simple: MSP compliance […]