The Official Medicare Set Aside Blog And Information Resource

Acupuncture Is Coming Soon to an MSA Near You: CMS Issues Decision to Cover Acupuncture for Medicare Beneficiaries

CMS, Medicare, Medicare Set-Aside Blog, MSP News, Opioids on January 22, 2020
Posted by Jean S. Goldstein, JD, CMSP

Yesterday, CMS issued a decision to cover acupuncture for Medicare patients with chronic low back pain (cLBP) to some extent.  You may recall that CMS previously issued a proposed decision to cover acupuncture, as we discussed here on our blog.  CMS’ final coverage decision memo can be found here, and indicates that acupuncture for chronic […] Continue

CMS Hosts Townhall Meeting to Address MSP Recovery Topics and Statute of Limitations

CMS, Conditional Payments, Mandatory Insurer Reporting, Medicare Set-Aside Blog on January 21, 2020
Posted by Jean S. Goldstein, JD, CMSP

Last week, on January 14th, the Centers for Medicare & Medicaid Services hosted a townhall meeting, complete with a slide presentation to discuss several Medicare Secondary Payer Recovery topics.  During the townhall meeting, CMS discussed the conditional payment recovery process along with providing time at the end of the presentation for questions.  The slides from […] Continue

Warning: Another Law Firm Reprimanded for Failing to Repay Medicare Conditional Payments

Compliance, Conditional Payments, Medicare Set-Aside Blog, MSP News on January 9, 2020
Posted by Jean S. Goldstein, JD, CMSP

Yesterday, the U.S. Department of Justice’s Attorney’s Office for the Eastern District of Pennsylvania issued a press release stating that another Philadelphia-based personal injury law firm, has entered into a settlement agreement with the United States to resolve allegations that it failed to reimburse Medicare Conditional Payments.  You may recall we saw a similar action […] Continue

State-Imposed Restrictions on Gabapentin

Medicare Set-Aside Blog, MSAs, Rx/Pharmacy on January 8, 2020
Posted by Leah King, PharmD, JD, Independent Pharmacy Consultant

In recent years, we have seen a growing number of instances where federal law and state law are not in perfect alignment with regard to certain medications. As one example, we’ve seen a number of states pass laws allowing for the medical and/or recreational use of marijuana compounds even though marijuana is classified as a […] Continue

Department of Health and Human Services Issues New Opioid Guidelines

Medicare Set-Aside Blog, Opioids, Rx/Pharmacy on December 18, 2019
Posted by Leah King, PharmD, JD, Independent Pharmacy Consultant

This past July, CMS issued an educational piece that warned of the dangers associated with the concurrent use of opioids and benzodiazepines. You may have seen our blog on the CMS publication. If you missed that blog, you can read it here. In October, the Department of Health and Human Services (HHS) issued guidelines on […] Continue