The Official Medicare Set Aside Blog And Information Resource

SPARC Act/Part D Prescription Drug Reform Reintroduced. What Does It Mean for MSP Recovery?

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on February 24, 2017 | Posted by Jean S. Goldstein, JD

In September 2016, House Representative Bill 6120 known as the Secondary Payer Advancement, Reconciliation, and Clarification (SPARC) Act was first introduced to Congress.  The bill did not pass at that time, but was just recently reintroduced into the House of Representatives as HR 1122.  Text of the recent bill is not yet available. The bill […] Continue

WCRC RFP Due Date Revised, Again.

CMS, Medicare Set-Aside Blog, Medicare Set-Asides on February 10, 2017 | Posted by Jean S. Goldstein, JD

CMS just issued an additional amendment to the RFP for the WCMSA review contractor. The amendment published additional responses to questions by offerors, and also a change in the due date for proposals to 10:00 am February 15, 2017. The amendment to the solicitation can be found here. Stay tuned for more details. Continue

WCRC RFP Due Date Revised

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on January 20, 2017 | Posted by Jean S. Goldstein, JD

Yesterday, CMS issued an amendment to the RFP for the WCMSA review contractor. The amendment published responses to questions by offerors, and informed offerors that additional answers to questions will be released on January 25, 2017. The amendment also reflects a change in the due date for proposals, to 10:00 am February 8, 2017. The […] Continue

Inclusion of CT Scans Instead of MRI Scans in WCMSAs for Claimants with Intrathecal Pumps

FDA, Medicare Set-Aside Blog, Medicare Set-Asides on January 12, 2017 | Posted by Erin O'Neill, PA-C, JD

It is commonplace for CT scans to be included in WCMSAs, in lieu of MRI scans, for Claimants with implanted intrathecal pumps; however, little thought is given to the reason for this substitution. Intrathecal pumps are small implanted programmable battery powered devices that dispense medication which is carried directly to the spinal cord by a […] Continue

FINALLY—The Bid for the Workers’ Compensation Review Contractor (WCRC) Has Been Released.

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on December 29, 2016 | Posted by Jean S. Goldstein, JD

CMS finally issued the solicitation for the Workers’ Compensation Review Contractor (WCRC) to review and evaluate workers’ compensation Medicare set-aside arrangements (WCMSA) submitted to CMS for review.  The WCRC’s role is to project future medical costs for those cases submitted as related to a workers’ compensation injury, illness, or disease that would otherwise be reimbursable […] Continue

2017: Shaping Up to Be the Year of CMS Changes

CMS, Medicare Set-Aside Blog, Medicare Set-Asides on December 22, 2016 | Posted by Jean S. Goldstein, JD

Just yesterday, CMS announced that in the coming year it will update its existing re-review process to specifically address cases where settlement has not occurred and a Claimant’s care has changed substantially since CMS issued an approval.  In the announcement, CMS also indicated that the re-review process will address situations for states that rely on […] Continue

Draft RFP for WCRC Released…Again.

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on November 30, 2016 | Posted by Jean S. Goldstein, JD

CMS recently released a draft RFP for a new Workers’ Compensation Review Contractor (WCRC) to review WCMSAs once again.  The draft RFP can be found here (Solicitation No: RFP-CMS-2016-8A-0008). Comments on the proposed RFP must be submitted by December 7, 2016, with the official solicitation for a new WCRC to be released in December.  The […] Continue

Stealth Guided and Robotic Assisted Surgeries – Coming to an MSA Near You?

CMS, Medicare Set-Asides on November 29, 2016 | Posted by Erin O'Neill, PA-C, JD

Over the past several years, there have been significant advances in surgical techniques across all fields of medicine. Two of these advances, robotic assisted surgery and stealth guided surgery have gained popularity as the technology becomes available at increasing numbers of hospitals across the country. Robotic assisted surgery had its beginnings in 1985; however, in […] Continue

Is an MSA Technically a Trust?

Medicare Set-Aside Blog, Medicare Set-Asides, MSA Administration, MSP News on November 17, 2016 | Posted by Jennifer Jordan, JD, MSCC

In the early days of Medicare set-asides, we used to see the word “trust” thrown around quite freely. But from a legal perspective, the word trust carries very specific legal connotations that people didn’t want attached to MSAs, so little by little we saw the use of the word disappear. If professionally administered, you will […] Continue