Government Shutdown Affects the Medicare Set Aside Review Process

CMS, Medicare Set-Aside Blog, News and Events on October 4, 2013 | Posted by Jean S. Goldstein, JD

The U.S. government shutdown has entered its fourth day today and with no end to the deadlock in sight. Unfortunately, the government shutdown has affected the Workers’ Compensation Medicare Set Aside review process. We have confirmed that operations at the WCRC, the agency responsible for review of MSA submissions, will continue as normal. However, the CMS Regional Offices are not fully operational at this time. Each office is unable to respond to inquiries. In calling most of the CMS Regional Offices, you will be greeted with the following message: Due to the absence of either a fiscal year 2014 appropriation, or a continuing resolution for the Department of Health and Human Services, our offices are on furlough and we are not able to respond to your message.

In addition, as a result of the shutdown we suspect that final approvals of MSAs, which are issued by the CMS Regional Offices will not be processed during the shutdown. Unfortunately, there may also be increased delays in receiving approvals of submitted MSAs once operations continue, as the backlog will surely continue to increase with each day that the shutdown continues. We hope this will not significantly impact the quick turnaround time so many of us eagerly await and need to resolve claims. We will continue to monitor the situation and stay in contact with the CMS Regional Offices, and hope for the best- that a resolution is soon forthcoming.