Workers’ Comp Advisor will take its annual winter break starting Monday, Dec. 23, 2024 and resume daily publication on Friday, Jan. 3, 2025. Happy Holidays to all of our valued subscribers!

Pennsylvania Standard Wage Set to Increase to $1,347

• The Dec. 14 edition of the Pennsylvania Bulletin includes a Notice from the Department of Labor and Industry that the maximum weekly compensation payable under the Workers’ Compensation Act will be $1,347 for injuries occurring on or after Jan. 1, 2025.
• For medical treatments rendered on or after that date, fee schedule-tied payments will increase by 1.7%.
• The increase is based on the Statewide Average Weekly Wage for the fiscal year ending June 30, 2024.
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2025 Medicare Recovery Thresholds Remain at $750

• The Centers for Medicare & Medicaid Services said this week that the long-standing $750 Medicare recovery threshold will be unchanged for 2025. 
• CMS on Monday published its annual update regarding conditional payment recovery and mandatory insurer reporting thresholds for certain liability, no-fault and workers compensation settlements.
• Despite inflation and increasing medical costs, CMS has continued to maintain the $750 threshold for almost a decade. In its explanation of the methodology used to calculate the threshold amount CMS noted that the average cost of collection is $339, which is nearly an 8% increase from last year’s $315 cost of collection.
• “Notably, these figures from CMS only mention costs incurred by the Benefits Coordination & Recovery Center (BCRC), and there is no mention or calculation of what costs of collection the Commercial Repayment Center (CRC) incurs in its recovery process,” the Sanderson Firm wrote in a Dec. 18 blog post.
• “As CMS utilizes two contractors for its conditional payment recoveries, both the BCRC as well as the CRC, it does seem questionable why the CRC’s costs were not considered in calculating the CMS thresholds. The CRC is primarily responsible for recoveries of conditional payments in workers’ compensation and no-fault claims where Ongoing Responsibility for Medical (ORM) has been reported,” noted the Bradenton, Florida law firm.
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NJ Court Rules Hartford Not Required to Defend Workplace Injury Suit

• The New Jersey Supreme Court ruled on Dec. 12 that Hartford Underwriters Insurance Co. has no obligation to defend against a negligence lawsuit filed by a worker who was injured on the job.
• In Dionicio Rodriguez v. Shelbourne Spring LLC. Rodriguez was injured while working for SIR Electric LLC. 
• After filing for workers compensation benefits, he sued SIR and nine other business owners, including Shelbourne Spring LLC, alleging negligence, gross negligence, recklessness and intentional wrongdoing.
• Hartford Underwriters was SIR’s insurer and it argued that it didn’t have an obligation to provide a defense due to policy language that excluded intentional harm claims. 
• SIR filed a third-party complaint against the Hartford Financial Services Group Inc. unit claiming it wrongfully disclaimed defense coverage.
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LWCC Acquiring Prescient National

• Louisiana-based Louisiana Workers’ Compensation Corporation (LWCC) is acquiring 100% of Prescient National.
• LWCC operates as a monoline WC writer providing coverage in Louisiana. PNIC provides WC coverage in multiple states. Both companies are expected to continue to operate as separate brands and entities, with some risk management oversight by LWCC.
• The transaction is an all-cash transaction, which has received regulatory approval and is expected to close by year-end 2024.
• AM Best issued a comment that the Financial Strength Rating of A (Excellent) and the Long-Term Issuer Credit Rating of a+ (Excellent) of LWCC are unchanged.
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