The Official Medicare Set Aside Blog And Information Resource

CMS Issues Revised and Modified Pre-Solicitation Notice

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides, News and Events on September 7, 2016 | Posted by Jean S. Goldstein, JD

We have been reporting over the last several months that CMS was soliciting bids for an RFP for the Workers’ Compensation Review Contractor (WCRC), to review WCMSA proposals.  We have been anxiously awaiting CMS’ revised and modified pre-solicitation notice, which was previously scheduled to be out in June.  Well, today, it’s finally out.  The pre-solicitation […] Continue

Naloxone, the Antidote, and the Effect on CMS Approvals

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MEDVAL News on September 1, 2016 | Posted by Jean S. Goldstein, JD

It is well known that we are still in an opioid crisis.  As reported, opioids were involved in16,235 deaths in 2013 and 28,647 deaths in 2014 and overdoses from opioids have quadrupled since 2000.  Yet, we consistently continue to see Claimants provided with prescriptions for opioids, even with the CDC’s issued guidelines for opioid prescriptions […] Continue

MSA Company Not Liable for Underfunding MSA

CMS, Jen Article, Medicare Set-Asides, Work Comp on August 26, 2016 | Posted by Kimberly Wiswell, CMSP

All these years later and Mr. Bindrum is still mad about his 2008 settlement with AIG. Today an unpublished opinion was reported out of the State of Vermont that shows that after his unsuccessful suit against AIG in federal court for wrongfully delaying his settlement while waiting on CMS approval during the backlog years and […] Continue

Possible furloughs for the Social Security Administration in the future?

Medicare Set-Aside Blog, Social Security on August 12, 2016 | Posted by Jean S. Goldstein, JD

There’s been talk and chatter about the possibility of Social Security Offices and staff being furloughed in the near future.  Nearly three years ago, in 2013, we experienced the government shut down, and extreme delays in the processing of everything from CMS’ review of Medicare Set Asides to Social Security Verifications.  Should furloughs occur in […] Continue

More MSPA Claims 1 Cases Dismissed

Commentary, Medicare Set-Aside Blog, MSP Litigation on August 10, 2016 | Posted by Jennifer Jordan, JD, MSCC

In its continuing efforts to bring MSP recovery claims against all PIP insurers in Florida under an alleged assignment from a now defunct Medicare Advantage Organization, MSPA Claims 1, LLC has had two more of its federal cases dismissed. What is unique about these two dismissals is that they are based on the various assignments […] Continue

MSPA Claims 1, LLC cases Remanded Back to State Court

Commentary, Medicare Set-Aside Blog, MSP Litigation on July 15, 2016 | Posted by Jennifer Jordan, JD, MSCC

In the ongoing pursuit of PIP reimbursements with double damages under the Medicare Secondary Payer Act, two MSPA Claims 1 cases have been remanded back to state court. Because early cases failed in federal court on the basis of plaintiff being required to actually demonstrate responsibility before filing suit, MSPA Claims 1 moved its efforts […] Continue

A Reminder that there is no MSP Reimbursement Obligation Until CMS Makes a Demand

Commentary, Medicare Set-Aside Blog, MSP Litigation on July 14, 2016 | Posted by Jennifer Jordan, JD, MSCC

While always entertained by pro se plaintiffs who take on the man, an interesting MSP opinion came out of the Eastern District of NY on July 11, 2016. Upon receipt of a conditional payment letter, indicating that Medicare had paid $678.60 for treatment related to his accident and in large, bold letters that it was […] Continue

Finally, June 27

CMS, Liability, Medicare Set-Aside Blog on June 27, 2016 | Posted by Jean S. Goldstein, JD

Today is June 27, the first day indicated by CMS as the target date CMS anticipated releasing the adjusted solicitation for the new Workers’ Compensation Review Contractor (WCRC).  We, at MEDVAL, are eagerly awaiting the revised solicitation to determine if in fact the new solicitation will reflect the review of liability MSAs.  We are sitting […] Continue

Medicare Trustees Announce Trust Fully Funded Through 2028

CMS, Medicare, News and Events on June 22, 2016 | Posted by Jennifer Jordan, JD, MSCC

CMS News FOR IMMEDIATE RELEASE June 22, 2016 Contact: CMS Media Relations (202) 690-6145 | CMS Media Inquiries Medicare Trustees Report Shows Continued Slow Cost Growth Today, the Medicare Trustees projected that the trust fund financing Medicare’s hospital insurance coverage will remain fully funded until 2028, 11 years longer than they projected in 2009 before […] Continue

C&R Rescinded Because Applicant was not Informed of Risks Associated with not Obtaining CMS Approval

Medicare Set-Aside Blog on June 21, 2016 | Posted by Jennifer Jordan, JD, MSCC

A noteworthy panel decision was reported out of California this week involving the WCAB rescinding the WCJ’s order approving the parties’ C&R due to an alleged “mutual misunderstanding” regarding the MSA. The case involved a $39,000 settlement with $11,040 permanent disability advances and $5,858 worth of attorney fees, leaving the applicant with a net recovery […] Continue