The Official Medicare Set Aside Blog And Information Resource


CMS, Medicare Set-Asides, WCRC on November 6, 2019
Posted by Jean S. Goldstein, JD

Last week, in a pre-Halloween treat mode, CMS released a revised Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide.  The updated guide is version 3.0, dated October 10, 2019, and can be found here.  As with other versions of the guide, updates are found in Section 1.1.  Of the updates, there are two of great significance […] Continue

CMS Issues Revised Self-Administration Toolkit for WCMSAs, Version 1.3

CMS, Medicare Set-Asides, Professional Administration on October 18, 2019
Posted by Jean S. Goldstein, JD

The Centers for Medicare & Medicaid Services (CMS) issued a revised Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside (WCMSA) Arrangements, version 1.3 yesterday. The purpose of this toolkit is to describe the WCMSA self-administration process and provide guidelines for claimants who are administering their own WCMSA.  Specifically, the toolkit: Describes the self-administration process, from when […] Continue

CMS Releases Updated Section 111 NGHP User Guide; Still No Word On Civil Money Penalties

CMS, Mandatory Insurer Reporting, MSP News on October 16, 2019
Posted by Jean S. Goldstein, JD

Many of us in the industry continue to wait with bated breath for information related to a proposed rule for Civil Money Penalties for Medicare Secondary Payer (MSP) Reporting.  You may recall our recent blog postings announcing an advanced notice of a proposed rule involving MSP reporting, and a subsequent update to the notice, which […] Continue

Ninth Circuit: Guaranty Fund Is Not Deemed a Primary Plan as Related to Non-Covered Claims; States No Obligation to Reimburse Medicare Conditional Payments on Subset of Claims

CMS, Conditional Payments, MSP Litigation, MSP News on October 15, 2019
Posted by Jean S. Goldstein, JD

Last week, the Ninth Circuit United States Court of Appeals issued an important decision involving the Centers for Medicare & Medicaid Services, and the California Insurance Guaranty Fund (CIGA) in Cal. Ins. Guarantee Ass’n v. Azar, Nos. 17-56526, 17-56528, 2019 U.S. App. LEXIS 30339 (9th Cir. Oct. 10, 2019). We last discussed this case in […] Continue

Addition of Open Debt Report Function to the Medicare Secondary Payer Recovery Portal (MSPRP) and Two New Portal User Guides Issued

CMS, Conditional Payments, Medicare Secondary Payer Recovery Portal, MSP News on October 8, 2019
Posted by Jean S. Goldstein, JD

You may have seen our blog post on Friday, regarding an alert from the Centers for Medicare & Medicaid Services (CMS) regarding two upcoming webinars to highlight a new electronic attestation feature on the Workers’ Compensation Medicare Set-Aside portal.  CMS also issued an alert on Friday morning regarding an additional enhancement to the Medicare Secondary […] Continue