The Official Medicare Set Aside Blog And Information Resource

CMS Issues Alert Regarding Zero-Dollar WCMSAs

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

CMS issued an alert this morning indicating that “CMS recently received inquiries regarding procedural changes in the way that CMS’ Workers’ Compensation Review Contractor (WCRC) reviews proposed zero-dollar Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) amounts.  CMS determined changes had transpired without prior notification. Effective immediately, the WCRC will utilize procedures that were previously in effect. […] Continue

Update: CMS Review Contractor Solicitation and Award Date Delayed

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides, News and Events on October 6, 2016 | Posted by Jean S. Goldstein, JD

As you know, we have been anticipating the release of CMS’ final solicitation for bids for an RFP for the Workers’ Compensation Review Contractor (WCRC) to review WCMSA proposals.  The pre-solicitation bid was to be released on September 22, 2016.  However, September 22, came and went without the release of the solicitation.  We finally received […] Continue

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

CMS Announces LMSA Review Program

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides on June 10, 2016 | Posted by Jean S. Goldstein, JD

On June 9, 2016, CMS officially validated rumors that it is in fact considering reviewing LMSAs. Announcement of the proposal and subsequent town hall meetings are expected later in the year. The alert (which can be found here) indicated that CMS is considering expanding its voluntary Medicare Set-Aside Arrangements (MSA) amount review process to include […] 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

CMS Considering IMR Determinations More Favorably

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, State Regulations on February 5, 2016 | Posted by Jean S. Goldstein, JD

An interesting and exciting turn of events has occurred within the last week, and we are pleased to report that we have begun to notice a change in the manner by which CMS is considering Independent Medical Review determinations (IMRs).  Over the last two years, MEDVAL has played an instrumental role in assisting in educating […] Continue

Will the Supreme Court Help Us Figure Out What Will Happen When MSA Funds are Improperly Spent?

Commentary, Medicare Set-Asides, News and Events on November 9, 2015 | Posted by Jennifer Jordan, JD, MSCC

Theoretically CMS is supposed to deny related Medicare payments until such a time that it can be proven that an MSA was properly exhausted on related medical treatment. It is then that the question arises as to what will happen if the Claimant used the money and can’t pay for this own medical expenses. Our […] Continue