The Official Medicare Set Aside Blog And Information Resource

CMS Webinar Held Today: Changes to the Medicare Secondary Payer Recovery Portal Are Coming

CMS, Medicare Secondary Payer Recovery Portal, MSP News on December 18, 2018
Posted by Jean S. Goldstein, JD

Today, the Centers for Medicare & Medicaid Services held a high level overview webinar of the upcoming Medicare Secondary Payer Recovery Portal (MSPRP) enhancements, which as you may recall we addressed in our recent blog post:  Medicare Secondary Payment Recovery Portal (MSPRP) to Allow for Self-Reporting: Coming January, 2019. The purpose of the webinar was […] Continue

The Opioid Crisis: What is the Government Doing About It? Part 4 – Increasing the Availability of Overdose-Reversing Drugs

FDA, Opioids, Rx/Pharmacy on December 17, 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 the first […] Continue

MSP Reporting Penalties…Are Reporting Penalties Finally Coming to Fruition?

CMS, Mandatory Insurer Reporting, MSP News on December 12, 2018
Posted by Jean S. Goldstein, JD

The Medicare Medicaid SCHIP Extension Act of 2007 (MMSEA) imposed Mandatory Insurer Reporting obligations on all Responsible Reporting Entities (RREs).  These mandatory requirements impart obligations on RREs, and require these entities to provide the Centers for Medicare and Medicaid Services (CMS) with data on claims that involve Medicare beneficiaries.  Furthermore, pursuant to the Strengthening Medicare […] Continue

CMS to Begin Utilizing 2015 Life Table

CMS, Medicare Set-Asides, MSP News on December 11, 2018
Posted by Jean S. Goldstein, JD

Starting January 5, 2019, the Centers for Medicare and Medicaid Services (CMS) will begin using the CDC’s “Table 1: Life Table for the total population: United States, 2015” for Workers’ Compensation Medicare Set Aside (WCMSA) life expectancy calculations.  This means that for any WCMSA proposal received by CMS, or where any WCMSA case is reopened […] Continue

CMS Adds a Proposed Rule – Will it Affect Your Workers’ Compensation and Liability Claims?

CMS, Medicare Set-Asides, MSP News on December 10, 2018
Posted by Jean S. Goldstein, JD

The Centers for Medicare & Medicaid Services (CMS) recently added an item to the Unified Agenda, which may have an impact on your claims.  The Unified Agenda of Federal Regulatory and Deregulatory actions is a semiannual compilation of information about regulations under development by federal agencies published in the spring and fall.  The item added […] Continue

FDA Awards Six-Month Patent Extension for Lyrica

FDA, MSP News, Rx/Pharmacy on November 30, 2018
Posted by Complex Claims Division

You may recall our earlier blog this week about Lyrica in the News.  Once again, the spotlight is on Lyrica.  First, after Pfizer was awarded a six-month patent extension based on a new pediatric indication for the drug.  Earlier this month, the Supreme Court in the United Kingdom ruled against Pfizer in a longstanding patent […] Continue

Lyrica In the News

CMS, MSP News, Rx/Pharmacy on November 26, 2018
Posted by Complex Claims Division

Lyrica and its manufacturer Pfizer have been in the news quite frequently this month, and the publicity has not been positive.  Most recently, on November 14th, the Supreme Court of the United Kingdom (U.K.) ruled against Pfizer in a patent infringement lawsuit that has spanned the past several years. It’s no secret that pharmaceutical manufacturers […] Continue

CMS Will Maintain $750 Recovery Threshold for 2019

CMS, Conditional Payments, Mandatory Insurer Reporting on November 21, 2018
Posted by Jean S. Goldstein, JD

The Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act) requires the Centers for Medicare & Medicaid Services (CMS) to publish an annual threshold for recovery in November, each year.  This threshold amount reflects an amount for which CMS will not spend more on collections than a claim is likely to yield.  In […] Continue

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