The Official Medicare Set Aside Blog And Information Resource

Final Rule Regarding Expansion of the Functionality of the Medicare Secondary Payer Recovery Portal

CMS, Conditional Payments, MSP News on May 19, 2016 | Posted by Erin O'Neill, PA-C, JD

On May 17, 2016, The Centers for Medicare and Medicaid Services (CMS) released the final rule, specifying the timeline and process for expansion of the current Medicare Secondary Payer Recovery Portal. The Final Rule, entitled Medicare Program; Obtaining Final Medicare Secondary Conditional Payment Amounts via Web Portal was published in the Federal Register and can […] Continue

Purdue Pharma Should Have to Supplement MSAs

Commentary, Medicare Set-Aside Blog, News and Events on May 13, 2016 | Posted by Jennifer Jordan, JD, MSCC

On May 11, 2016, Circuit Judge Steven Coms in Pike County, Kentucky, ruled to unseal records related to a 2007 suit brought by the State’s Attorney General against OxyContin manufacturer Perdue Pharma. The suit was settled in December with no admission of liability and a measly $24 million dollar contribution to the state coffers. As […] Continue

Humana Stretches Boundaries of MSP Private Cause of Action Again

CMS, Commentary, Medicare Set-Aside Blog, MSP Litigation on May 11, 2016 | Posted by Jennifer Jordan, JD, MSCC

In the Fourth Circuit, Humana is currently pursuing reimbursement from the attorneys representing a passenger in a motor vehicle action under the persons in receipt of settlement funds provision of the MSP in yet another attempt to get the courts to grant Medicare Advantage Organizations (MAOs) the same rights as the federal government with regard […] Continue

FDA Advisory Committees Weigh in on New Abuse-Deterrent Opioid Medications

Medicare Set-Aside Blog, Rx/Pharmacy on May 5, 2016 | Posted by Erin O'Neill, PA-C, JD

On the heels of the release of the FDA’s guidelines for the development of generic formulations for abuse-deterrent opioid medications, the FDA Advisory Committees have weighed in on several proposed abuse-deterrent opioid medications. On April 26, 2016, the U.S. Food and Drug Administration (FDA) approved a new long-acting opioid medication designed for the management of […] Continue

The MSP is not so “Extraordinary” that it Completely Preempts State Law

CMS, Commentary, Medicare, Medicare Set-Aside Blog, MSP Litigation on May 4, 2016 | Posted by Jennifer Jordan, JD, MSCC

Great MSP case reported out of Pennsylvania on May 3, 2016 involving what the MSP does not do, in particular, preempt state law under any circumstances. From the brief facts presented in the background,  it is clear that the parties arrived at a lump sum settlement agreement and that the insurer attempted to button up […] Continue

MEDVAL Awarded Best Blog Designation for 2016

Commentary, Medicare Set-Aside Blog, MEDVAL News, News and Events on May 3, 2016 | Posted by Jennifer Jordan, JD, MSCC

In 2015, the workers’ compensation blogger community was saddened by LexisNexis’ decision to discontinue its top blogs awards. However Bob Wilson and some like-minded cohorts decided that need not be the end of a good thing. In an age where anyone with an internet connection has a voice, separating the wheat from the chaff is […] Continue

A portent of things to come? CMS releases revised WCRC contract pre-solicitation

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides, News and Events on April 19, 2016 | Posted by Kimberly Wiswell, CMSP

CMS has revised their pre-solicitation for the WCRC contract with the following statement: ATTENTION: RFP-CMS-2016-8A-0008 PRE-SOLICITATION notice has been updated as follows. The Centers for Medicare and Medicaid Services (CMS) has adjusted the referenced solicitation for the Workers’ Compensation Review Contractor (WCRC) due to updates that are currently being made to the Statement of Work (SOW) […] Continue

Additional Updates to the WCMSA Reference Guide

CMS, ICD-10, Medicare Set-Aside Blog on April 18, 2016 | Posted by Jean S. Goldstein, JD

An updated and revised WCMSA reference guide was just issued today.  The revised guide, version 2.5, can be found here. The revised WCMSA reference guide has two minor updates, both of which CMS has been addressing in the past couple of months, and which we have discussed here on our blog.  The first update piggybacks […] Continue

The Opioid Crisis: A Call to Action

Rx/Pharmacy on March 25, 2016 | Posted by Abidemi Oyebode, R.Ph., MBA - Clinical Pharmacist

The National Survey on Drug Use and Health (NSDUH) showed that in 2012 about 2.1 million Americans were addicted to opioid pain medications, roughly 467,000 addicted to heroin and about 2.5 million Americans with opioid use disorder but receiving legitimate prescriptions.  According to the CDC, opioids were involved in 16, 235 deaths in 2013 and […] Continue