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, CMSP

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 by Medicare.  Final bids for the proposal are due on January 30, 2017 at 10:00 am, with an anticipated award date of June 30, 2017.  The contract term will begin on July 1, 2017 and will run through June 30, 2022. The full solicitation can be found here. The release of the RFP comes on the heels of CMS’ most recent announcement regarding implementing a WCMSA re-review process.

The solicitation suggests that the review process for Liability Medicare Set-asides (LMSA) and No-fault Insurance Medicare Set asides (NFMSA) is still in the planning phase, such that review of these MSAs would not begin until at least July 1, 2018.  While it remains to be seen whether the review of LMSAs and NFMSAs will come to fruition, it is clear as documented within the solicitation that CMS expects the volume of MSA submissions to increase, despite the voluntary nature of the CMS review program.

For those that are curious, the solicitation states that the general procedure for award of a contract of this nature is to consider and assess the technical and business proposal submitted, that in the Government’s perspective provides the best value.  It remains to be seen what is considered the “best value.”  CMS further intends to award the contract to an entity certified by the Small Business Administration.

We will keep you apprised of any new developments as we learn of them, but as we have been saying— 2017 will certainly be the year of CMS changes.