The portal's Resources page (Figure 1) provides a collection of forms that your firm needs to participate in the Asbestos Non-Malignancy Global Resolution Program.
Figure 1. The Resources page.
Use this workbook to populate the necessary data points in order to enroll your firm’s claimant (s) to a universe. In the Forms section, click the Enrollment Workbook link to download a blank copy of the Asbestos Enrollment Workbook template.
In the Other Resources section, click the Claimant Category Legend link to open the current version of this legend. The legend lists all of the claimant status categories used in the Asbestos Non-Malignancy Global Resolution Program, and shows the acronyms for each category. The acronyms appear in the claimant detail report.
The following types of forms are available in the Form Type drop-down menu:
Certification of injury. Use this form to certify the submission of your Levels I-III Asbestos Non-Malignancy claimants. The form must be completed to satisfy Medicare's interest under the Global Resolution Process. NOTE: An additional "Injury Certification Form" will be required for each enrollment submission.
Certification of exposure. Use this form to certify the exposure of your Levels I-III Asbestos Non-Malignancy claimants. The form must be completed to satisfy Medicare's interest under the Global Resolution Process. NOTE: If all exposure fields were not previously populated in the enrollment state, GRG will notify your firm via email to complete an Exposure Screening Workbook.
Registration form. Use this form to register and certify to certain terms and requirements under the Non-Malignancy program.
Universe I & II Global resolution process. This letter is for informational purposes and outlines CMS’ terms of the Non Malignancy program.
Asbestos Non-Malig GFRG Process Universe Letter. A letter will available for each universe in which you have enrolled at least one claimant. The document outlines any changes applicable to the universe and confirms the start and end dates for each universe.
Take the following steps to view a form:
Click the Litigation Firm Name drop-down arrow and select your firm's name. This pre-populates the form with firm-specific information.
Click the Form Type drop-down arrow and select the form you need.
Click View Form. The form opens in your PDF viewer, ready to be saved, printed, and completed. Once completed, the form must be scanned back into your system for uploading to GRG. For directions, see Uploading Documents.