The Official Medicare Set Aside Blog And Information Resource

MEDVAL’s Blog Named The Best Blog in the MSP Industry

Medicare Set-Aside Blog, MSP News, News and Events on May 23, 2018 | Posted by Jean S. Goldstein, JD

MEDVAL’s blog, The Official Medicare Set Aside Blog And Information Resource, has been selected as the best blog in the Medicare Secondary Payer Industry by workerscompensation.com. We sincerely want to thank all of our loyal readers who took a moment to nominate us, as well as the esteemed panel of judges for this prestigious accolade.  It […] Continue

H.R.5881 Introduced in An Effort to Add Transparency to MSP Reporting Information

CMS, Medicaid, Medicare, Medicare Advantage, Medicare Set-Aside Blog, MSP News on May 22, 2018 | Posted by Jean S. Goldstein, JD

Last week, Congressman Gus Bilirakis and Congressman Ron Kind introduced legislation (H.R. 5881) in the House of Representatives to amend title XVIII of the Social Security Act, specifically in an effort to provide for transparency of Medicare Secondary Payer (MSP) reporting information.  Congressman Bilirakis issued a press release yesterday stating that, “[t]his legislation will ensure […] Continue

Arizona SB 1100 Impacts Full and Final Settlements of Accepted Claims

Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, State Regulations on May 17, 2018 | Posted by Jean S. Goldstein, JD

Last month, Arizona Governor, Doug Ducey signed Senate Bill 1100 (SB 1100), which is a modification to the legislation allowing for full and final settlements.[1]  You may recall our initial blog on the ability to finally fully settle and close out a workers’ compensation claim in Arizona, under Senate Bill 1332 (SB 1332), as well […] Continue

CMS Issues Revised WCMSA Self-Administration Toolkit, Version 1.2

CMS, Medicare Set-Aside Blog, MSP News on May 7, 2018 | Posted by Jean S. Goldstein, JD

The Centers for Medicare & Medicaid Services (CMS) recently issued a revised self-administration toolkit, version 1.2. The purpose of the toolkit, just as with the previous version is outlined on page 3 of the 31 page guide, which is to describe the Workers’ Compensation Medicare Set-Aside (WCMSA) self-administration process and provide guidelines for claimants.  Specifically, […] Continue

New Nebraska Legislation Allows Parties to Determine How Medicare’s Interests Should be Considered in Certain Settlements

Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on April 26, 2018 | Posted by Jean S. Goldstein, JD

The Centers for Medicare & Medicaid Services (CMS) through various Memorandums and guides, has clearly stated that “[w]hile there are no statutory or regulatory provisions requiring that a (Workers’ Compensation Medicare Set Aside) WCMSA proposal be submitted to CMS for review, submission of a WCMSA proposal is a recommended process.”  Of significant note, the word […] Continue

Did the United States Court of Appeals for the Sixth Circuit Just Pave the Way for More MSP Private Causes of Action?

Medicare Set-Aside Blog, MSP Litigation, MSP News on April 18, 2018 | Posted by Jean S. Goldstein, JD

In today’s day and age of conditional payment recoveries, whenever a settlement of a claim is imminent, parties begin to worry about what possible challenges may impede the settlement, or even arise after settlement.  Yesterday, an interesting case from the United States Court of Appeals for the Sixth Circuit was issued; and while the fact […] Continue

CMS Posts Update of Medicare Part D Opioid Prescribing Mapping Tool

CMS, Medicare Set-Aside Blog, Opioids on April 17, 2018 | Posted by Jean S. Goldstein, JD

The Centers for Medicare & Medicaid Services (CMS) released an updated version of the Medicare Part D opioid prescribing mapping tool, providing an interactive, web-based resource that presents geographic comparisons- at the state, county, and ZIP code levels – of Medicare Part D opioid prescribing rates.  The tool allows users to understand and compare opioid […] Continue

CMS Issues Updates for Medicare Advantage and Prescription Drug Benefit Program: Will it Affect Your WCMSA?

CMS, Medicare Advantage, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, Opioids on April 5, 2018 | Posted by Jean S. Goldstein, JD

Earlier this week, CMS issued a policy change revising the Medicare Advantage Program (MAP) Part C regulations and Prescription Drug Benefit program (Part D).  The ultimate goal of the new policy is to ensure that individual’s treatment needs are met, while improving the quality of care and providing greater choices to MA enrollees.  The full […] Continue

CMS Increased Conditional Payment Demand by $142k: New York Supreme Court Vacates Settlement Agreement

CMS, Conditional Payments, Medicare Set-Aside Blog, MSP Litigation on March 26, 2018 | Posted by Jean S. Goldstein, JD

An interesting case came out of the Supreme Court of New York City on Friday, challenging whether a settlement agreement may be declared null and void based upon an erroneous assumption of the total sum of conditional payments made by Medicare.  Mayo v. NYU Langone Med. Ctr., 2018 NY Slip Op 30456(U) (Sup. Ct.). The parties litigated […] Continue

11th Circuit Finds MAOs May Bring Double Damages Private Cause of Action Against Medical Providers

CMS, Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation on March 21, 2018 | Posted by Jean S. Goldstein, JD

The 11th Circuit issued an opinion yesterday on a Motion to Dismiss on a claim addressing a new question, one they have never been faced with before: Whether an MAO has a private cause of action against the recipient, or a provider of a primary payment. Claims v. Bayfront Hma Med. Ctr., 2018 U.S. Dist. […] Continue