The Official Medicare Set Aside Blog And Information Resource

FDA Issues Safety Communication Regarding Medications Utilized in Intrathecal Pumps

FDA, MSP News, Rx/Pharmacy on November 20, 2018
Posted by Erin O'Neill, PA-C, JD

On November 14, 2018, the Food and Drug Administration (FDA) issued a safety communication to all patients with implanted intrathecal pumps, their caregivers and health care providers, and medication compounding companies warning of the dangers of utilizing medications in intrathecal pumps that have not specifically been approved for intrathecal pump use. Intrathecal pumps are programmable devices that […] Continue

Medicare Secondary Payment Recovery Portal (MSPRP) to Allow for Self-Reporting: Coming January, 2019

CMS, Medicare Secondary Payer Recovery Portal, MSP News on November 19, 2018
Posted by Jean S. Goldstein, JD

You may recall that several months ago, CMS held an informative webinar regarding the benefits of using the Medicare Secondary Payment Recovery Portal (MSPRP). During this webinar, CMS also announced several future enhancements coming to the MSPRP.  One of the upcoming enhancements is the ability to self-report.  CMS announced today that effective January 7, 2019, authorized […] Continue

Medicare’s Conditional Payment Recovery Process is Ramping Up:  What You Need to Know.

Conditional Payments, CRC, MSP News on November 14, 2018
Posted by Jean S. Goldstein, JD

Last month, at the annual National Alliance of Medicare Set-Aside Professionals’ Annual Conference, Performant Financial (Performant), the current contractor for the Commercial Repayment Center (CRC), held a timely panel question and answer session.  You may recall that we recently blogged about how the current conditional payment recovery process continued to terrorize many non-group health plans.  […] Continue

The Opioid Crisis: What is the Government Doing About It? Part 3 – The Promotion of Healthy, Evidence-Based Methods of Pain Management

Medicare Set-Aside Blog, MSP News, Rx/Pharmacy on November 2, 2018
Posted by Complex Claims Division

This blog series is devoted to better understanding the efforts our Federal government is undertaking to combat the opioid epidemic in America. Earlier this year, the Department of Health and Human Services (HHS) announced a five-part strategy that will be utilized to combat the opioid epidemic. In previous posts, we have focused on parts one […] Continue

Structured Settlements in the Field

CMS, Medicare Set-Asides, Structured Settlements on October 24, 2018
Posted by Katharine Rupp, JD

In our last blog about structured settlements we reviewed the basics of what a structured settlement is and why you would want to structure a settlement. However, the benefits of structuring a settlement are best shown through real life examples. Below are three scenarios in which MEDVAL was able to provide creative settlement solutions utilizing […] Continue

As MAPs Continue Recovery Efforts, Florida Court Says the MSP Does Not Preempt State Law

Medicare Advantage, MSP Litigation, MSP News on October 16, 2018
Posted by Jean S. Goldstein, JD

You may recall that we recently blogged about whether the Medicare Secondary Payer (MSP) Act, a Federal law, preempts State law.  A Maryland case quite succinctly addressed this question several months ago finding that State law is not preempted by the MSP if certain conditions are met.  This question was also addressed recently in a […] Continue

Inclusion of Lyrica in Workers’ Compensation Medicare Set-Aside Arrangements

Medicare Set-Asides, Rx/Pharmacy, WCRC on October 11, 2018
Posted by Complex Claims Division

Lyrica (pregabalin) is an analog of the neurotransmitter gamma-aminobutryic acid, or GABA. Within the brain and nervous system, GABA plays an important role in behavior, cognition and the body’s response to stressful situations. A deficiency in naturally-occurring levels of GABA has been linked to conditions such as schizophrenia, depression, anxiety and various sleep disorders.  While […] Continue

Updated Guides Issued: WCMSA Reference Guide and Section 111 Reporting Guide

CMS, Medicare Set-Asides, MSP News on October 4, 2018
Posted by Jean S. Goldstein, JD

An updated Workers’ Compensation Medicare Set-Aside (WCMSA) reference guide has been issued.  The revised guide, version 2.8, can be found here. The revised WCMSA reference guide includes the following updates: Fields formerly labeled as “HICN” have been relabeled as “Medicare ID” and can accept either an Health Insurance Claim Number (HICN) or the new Medicare Beneficiary […] Continue

Conditional Payments: When Does the Time Clock Run Out?

Conditional Payments, Medicare Advantage, MSP Litigation on October 1, 2018
Posted by Jean S. Goldstein, JD

Last week, in MSPA Claims 1 v. Kingsway Amigo Ins. Co.,  the 11th Circuit addressed the appropriate application of the statute of limitations under the Medicare Secondary Payer Act (MSPA).  At issue in the matter, was whether the Plaintiff, an assignee of a Medicare Advantage Organization (MAO), timely pursued a claim against the Defendant, a primary […] Continue

The Opioid Crisis: What is the Government Doing About It? Part 2 – Improvements with Data Reporting, Collection and Analysis

Medicare Set-Aside Blog, MSP News on September 20, 2018
Posted by Complex Claims Division

This blog series is devoted to better understanding the efforts our Federal government is undertaking to combat the opioid epidemic in America. Earlier this year, the Department of Health and Human Services (HHS) announced a five-part strategy that will be utilized to combat the opioid epidemic. In part one of this series, we examined the […] Continue