Through our partnership with LWP, CIRA members benefit from a dedicated Workers’ Compensation team focused on enhancing responsiveness to employees and facilitating a smooth return-to-work process. The team includes dedicated examiners, claims assistant supervisors, nurse advocates, and medical directors, all working together to manage treatment effectively and ensure timely communication with all parties involved. This comprehensive approach not only addresses employee needs but also plays a critical role in controlling costs. Below are the LWP team members assigned to support CIRA members.

This LWP User’s Guide offers a step-by-step approach to completing and submitting an Employer’s First Report of Injury (Form 5020) using LWP’s secure loss reporting portal.

We promote a ‘Zero Litigation Philosophy’ that ensures employees receive quality care and timely benefits without the need for legal intervention. If legal counsel becomes necessary, the Workers’ Compensation Defense Panel provides members with quality representation at various appeals boards.

CIRA maintains a comprehensive litigation management program aimed at assigning cases to the law firms best equipped to handle the defense, ensuring optimal outcomes and cost-efficient representation without compromising quality. Firms are selected based on their demonstrated success in defending public entities.

Medicare Compliance is applicable to both the General Liability and Workers’ Compensation Programs.

Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) established mandatory reporting requirements for Medicare beneficiaries receiving settlements, judgments, awards, or other payments from liability insurance (including self-insurance), no-fault insurance, or workers’ compensation. Collectively, these are referred to as Non-Group Health Plan (NGHP) insurance. The purpose of the Medicare Secondary Payer Act is to protect Medicare’s interests by ensuring it remains secondary to all other medical coverage when an injured person receives—or may receive—Medicare benefits. This requirement, which previously applied only to group health plans (GHP) and workers’ compensation, now extends to all forms of payers, including pools like CIRA and its individual members. More information about Mandatory Insurer Reporting can be found on the Centers for Medicare & Medicaid Services (CMS) website. If your agency issues payments to any injured person, either directly or through your TPA, you are considered a Responsible Reporting Entity (RRE) and must register with CMS. Neither your TPA nor CIRA can register as the RRE on your behalf. For claims involving existing or potential Medicare beneficiaries, there is no dollar minimum, and nuisance settlements are not excluded. The compliance trigger is any payment made to a Medicare-eligible person.

CIRA coordinates with its third-party claims administrators to report payments to CMS on our members’ behalf; therefore, registering and maintaining RRE status is the only step members need to take. It is imperative that members ensure their Profile Report is re-certified annually to facilitate reporting. This requirement primarily applies to members participating in the General Liability Program, as all workers’ compensation payments are issued by CIRA.