The Official Medicare Set Aside Blog And Information Resource

Medicare Trust Fund Exhaustion Pushed Back Until 2030

Medicare on July 28, 2014 | Posted by Jennifer Jordan, JD, MSCC

In its Trustees Report released July 28, 2014, CMS announced that the Medicare trust fund will remain solvent until 2030, four more years than previously projected, due in part to cost controls implemented in the Affordable Care Act. Factors that contributed to the improved outlook included lower than expected spending in 2013 and decreased overall […] Continue

Dueling MSA Recommendations

Commentary, Liability, Medicare Set-Aside Blog on June 30, 2014 | Posted by Jennifer Jordan, JD, MSCC

We knew it was inevitable but the day has come. The Court of Appeals of Ohio published an opinion within which the parties debate the need for an LMSA and use the polar extreme of MSA providers to argue their cases. Unlike dueling life care plans, this was not a case of high and low […] Continue

Hearing on the Merits

CMS, Medicare Set-Aside Blog, MSP Litigation on June 6, 2014 | Posted by Jennifer Jordan, JD, MSCC

Although I’m sure you’ve seen the abundant posts this week regarding the new WCMSA Reference Guide and are aware that CMS has added a new section, it looks like this: 4.1.4 Hearing on the Merits of a Case When a state WC judge approves a WC settlement after a hearing on the merits, Medicare generally […] Continue

CMS And WCRC Streamline Review Process To Clear Backlog

CMS, Medicare Set-Aside Blog, News and Events on May 13, 2014 | Posted by Jean S. Goldstein, JD

Over the past week, MEDVAL has received numerous calls from the CMS WC review contractor (“WCRC”) regarding closeout letters received in response to requests for additional information for many submissions. MEDVAL was advised that these closeout letters were apparently inadvertently issued, and that the WCRC was working with CMS to clear their backlog. We have […] Continue

Kimberly Wiswell Voted President-Elect by NAMSAP Board of Directors

Commentary, Medicare Set-Aside Blog, MEDVAL News, News and Events on May 12, 2014 | Posted by Jon Gunter, CMSP

Kimberly Wiswell, Director of Operations for MEDVAL, was voted President-Elect of the Board of Directors for the National Alliance of Medicare Set-Aside Professionals (NAMSAP). The nonprofit educates Medicare professionals, advocates for a more efficient and effective Medicare Secondary Payer process in Washington, participates in the federal rule-making process and helps draft Medicare-related legislation. In this […] Continue

The Importance of the Settlement Agreement

Commentary, Medicare Set-Aside Blog, Medicare Set-Asides, MSP Litigation on May 5, 2014 | Posted by Jennifer Jordan, JD, MSCC

I lecture often about the importance of settlement agreements in litigation involving MSAs. The one factor that you can consistently find throughout the limited body of case law involving MSAs is judicial emphasis on a meeting of the minds, usually as evidenced by the memorialization of the agreement among the parties in the settlement contract. […] Continue

CMS Publishes Self-Administration Toolkit

CMS, Medicare Set-Aside Blog, MSP News on April 11, 2014 | Posted by Jennifer Jordan, JD, MSCC

On April 11, 2014, CMS added an entire subsection to its WCMSA website for self-administration help. In the agency’s usual overreaching style, it has created requirements that are not supported by any law or regulation. While many of its suggestions are certainly the most logical approach to self-administering an MSA, the tone of the agency […] Continue

Zohydro ER – The New Actiq

CMS, Commentary, Medicare Set-Aside Blog, Rx/Pharmacy on April 4, 2014 | Posted by Jennifer Jordan, JD, MSCC

Yesterday MEDVAL did its first MSA evaluation for a California applicant taking Zohydo ER. We were genuinely shocked as this drug was not even expected to hit the market until March so we didn’t really anticipate seeing it included in MSAs until maybe the end of the year, if at all if common sense prevailed. […] Continue