The Official Medicare Set Aside Blog And Information Resource

Significant Price Changes for Meloxicam & Benefits to Your WCMSAs

Medicare Set-Aside Blog, MSAs, Rx/Pharmacy on April 2, 2020
Posted by Jean S. Goldstein, JD, CMSP

Mobic (meloxicam) is a nonsteroidal anti-inflammatory drug (NSAID) commonly seen in workers’ compensation claims.  It is most frequently prescribed to treat osteoarthritis (OA) starting at doses of 7.5 mg and may be increased to 15 mg daily to reduce pain, joint swelling, and stiffness in joints. Recently, the average wholesale price of this medication dropped […] Continue

Will the Expansion of Telehealth Services Lead to More Conditional Payments?

CMS, Conditional Payments, Medicare Set-Aside Blog, Telehealth on March 30, 2020
Posted by Jean S. Goldstein, JD, CMSP

In 2019, Medicare started covering some virtual care services. The services covered included brief communications and Virtual Check-Ins (short patient-initiated communications with a healthcare practitioner) along with E-visits (which are non-face-to-face patient-initiated communications through an online patient portal). However, telehealth services have generally not been covered. Historically, for telehealth services to be covered, certain circumstances […] Continue

Reminder: 04/01 Revised CMS Release Must be Used; Electronic Signatures: OK

CMS, MSAs, WCRC on March 23, 2020
Posted by Jean S. Goldstein, JD, CMSP

In just 9 days, the Centers for Medicare & Medicaid Services (CMS) will no longer accept a standard CMS release when submitting a Workers’ Compensation Medicare Set-Aside (WCMSA) for review and approval to the Workers’ Compensation Review Contractor, CMS’ independent contractor.   As noted in CMS’ most recently issued WCMSA Reference Guide, beginning on April 1, […] Continue

Social Security Administration Field Offices Are Closing; Do You Have a Compliance Game Plan?

Compliance, Medicare Set-Aside Blog, MSP News, Social Security on March 20, 2020
Posted by Jean S. Goldstein, JD, CMSP

Earlier this week, in an effort to help reduce the exposure of outside activities for our at-risk population, the Social Security Administration (SSA) announced that local offices are now closed to the public for in-person service.  The press release can be found here.  Local offices will continue to provide critical services over the phone.  In […] Continue

CMS to Begin Utilizing 2017 Life Table

CMS, Medicare Set-Aside Blog, MSAs, WCRC on March 18, 2020
Posted by Jean S. Goldstein, JD, CMSP

Starting April 25, the Centers for Medicare and Medicaid Services (CMS) will begin using the Center for Disease Control’s (CDC) “Table 1: Life Table for the total population: United States, 2017” for Workers’ Compensation Medicare Set Aside (WCMSA) life expectancy calculations.  This means that for any WCMSA proposal received by CMS through the voluntary review […] Continue