The Official Medicare Set Aside Blog And Information Resource

Updated WCMSA Reference Guide Issued

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, WCRC on May 15, 2020
Posted by Jean S. Goldstein, JD, CMSP

Today, the Centers for Medicare & Medicaid Services (CMS) released a revised Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide.  The updated guide is version 3.1, dated May 11, 2020, and can be found here. As with other versions of the guide, a summary of updates to the guide are found in Section 1.1. The only update […] Continue

Court Finds Defendant Made Good Faith Effort to Secure SSN to Comply With Section 111 Reporting Requirements

CMS, Mandatory Insurer Reporting, Medicare Set-Aside Blog, MSP Litigation on May 6, 2020
Posted by Jean S. Goldstein, JD, CMSP

As we recently blogged, the comment period for the Centers for Medicare & Medicaid’s (CMS) Section 111 Civil Money Penalties (CMPs) proposed rule closed. This rule contains the circumstances for when the imposition of CMPs would apply, along with some important guidelines of when CMPs would not be imposed based upon good faith efforts to […] Continue

Comment Period Closed for Section 111 Civil Money Penalties Proposed Rule

CMS, Mandatory Insurer Reporting, MSP News on April 22, 2020
Posted by Jean S. Goldstein, JD, CMSP

On Monday, the comment period for the Centers for Medicare & Medicaid’s (CMS) Section 111 Civil Money Penalties (CMPs) proposed rule closed.  Entities that are responsible for complying with Section 111 reporting, and subsequently which may be subject to CMPs are referred to as Responsible Reporting Entities (RREs).  These entities must provide specific data on […] 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