The Official Medicare Set Aside Blog And Information Resource

NEW Workers’ Compensation Review Contractor (WCRC) Contract Awarded

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, WCRC on September 5, 2017 | Posted by Jean S. Goldstein, JD

Finally, a new Workers’ Compensation Review Contractor (WCRC) award has been issued.  This news comes after several months of work being completed by Provider Resources, the incumbent contractor, under an expired contract.  The new WCRC contract was awarded on September 1, 2017 to Capitol Bridge, LLC of Arlington, Virginia, a certified small business entity.  Capitol […] Continue

Endo Pharmaceuticals Voluntarily Withdraws Opana ER From the Market: What Does This Mean For Your Cases?

CMS, Medicare Set-Aside Blog, MSP News, Opioids, Re-Review Process on July 11, 2017 | Posted by Erin O'Neill, PA-C, JD

On July 6, 2017, Endo Pharmaceuticals issued a statement indicating it would voluntarily withdraw the opioid pain medication, Opana ER, from the market, in response to the Food and Drug Administration’s request one month earlier. As noted in our prior blog post, the FDA requested that Endo Pharmaceuticals withdraw Opana ER from the market, citing concerns of […] Continue

Eyes on the Prize: A New CMS Re-Review Option is Available.

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, WCRC on July 10, 2017 | Posted by Jean S. Goldstein, JD

While all eyes (and ears) have been focused on the news, or the lack thereof of news regarding the Workers’ Compensation Review Contractor award, CMS quietly released a change to their re-review process today.  The change was released through CMS’ Workers’ Compensation Medicare Set-Aside Portal (WCMSAP).  Specifically, through a revised WCMSAP User Guide, which can […] 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

The Latest News Regarding Total Joint Replacement Procedures

CMS, Comprehensive Care For Joint Replacements, Outpatient Total Joint Replacement on July 13, 2015 | Posted by Erin O'Neill, PA-C, JD

Hip Knee Replacement Patients Leave Hospital Within Hours of Surgery  Cutting-Edge Outpatient Total Joint Replacement Program Helps Coastal Orthopedics Patients Heal Faster Articles, similar to the two noted in the links above, are beginning to appear in newspapers and journals across the country. Orthopedic surgeons are breaking new ground by performing total knee and total […] Continue

CMS Proposes Expansion of the WCMSA Re-review Process

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, News and Events on February 12, 2014 | Posted by Kimberly Wiswell, CMSP

On February 11, 2014, CMS released a request for comments concerning an expansion of their Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) re-review process.  In the past, requests for re-reviews have been limited to situations where the submitter omitted documentation or information from the original submission or where a mathematical error was made by the review […] Continue

Career opportunity with WCRC

Medicare Set-Aside Blog, News and Events on July 29, 2013 | Posted by Ryan Roth

Position: Workers’ Compensation Case Manager – Level II Review Provider Resources, Inc. (PRI) is the new Workers’ Compensation Review Contractor (WCRC) for the Centers for Medicare and Medicaid Services (CMS) and is seeking exceptionally talented and innovative Healthcare Professionals to support this program. PRI is now pursuing to hire individuals that have national reputations in […] Continue