The Official Medicare Set Aside Blog And Information Resource

CMS to Host Town Hall Meetings to Discuss Medicare Secondary Payer Recovery Topics

CMS, Conditional Payments, Medicare Set-Aside Blog, MSP News on December 5, 2019
Posted by Jean S. Goldstein, JD, CMSP

The Centers for Medicare & Medicaid Services issued an alert today that it will be hosting two town hall meetings to discuss common Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Ongoing Responsibility for Medicals (ORM) and Group Health Plan (GHP) recovery topics. The first town hall will be held on January 14, 2020 at 1:00 […] Continue

UPDATED WCMSA REFERENCE GUIDE EXPANDS AMENDED REVIEW TIMEFRAME TO 6 YEARS AFTER A CMS APPROVAL HAS BEEN ISSUED

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, WCRC on November 6, 2019
Posted by Jean S. Goldstein, JD, CMSP

Last week, in a pre-Halloween treat mode, CMS released a revised Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide.  The updated guide is version 3.0, dated October 10, 2019, and can be found here.  As with other versions of the guide, updates are found in Section 1.1.  Of the updates, there are two of great significance […] Continue

CMS Issues Revised Self-Administration Toolkit for WCMSAs, Version 1.3

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, Professional Administration on October 18, 2019
Posted by Jean S. Goldstein, JD, CMSP

The Centers for Medicare & Medicaid Services (CMS) issued a revised Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside (WCMSA) Arrangements, version 1.3 yesterday. The purpose of this toolkit is to describe the WCMSA self-administration process and provide guidelines for claimants who are administering their own WCMSA.  Specifically, the toolkit: Describes the self-administration process, from when […] Continue

CMS Releases Updated Section 111 NGHP User Guide; Still No Word On Civil Money Penalties

CMS, Mandatory Insurer Reporting, Medicare Set-Aside Blog, MSP News on October 16, 2019
Posted by Jean S. Goldstein, JD, CMSP

Many of us in the industry continue to wait with bated breath for information related to a proposed rule for Civil Money Penalties for Medicare Secondary Payer (MSP) Reporting.  You may recall our recent blog postings announcing an advanced notice of a proposed rule involving MSP reporting, and a subsequent update to the notice, which […] Continue

Ninth Circuit: Guaranty Fund Is Not Deemed a Primary Plan as Related to Non-Covered Claims; States No Obligation to Reimburse Medicare Conditional Payments on Subset of Claims

CMS, Conditional Payments, Medicare Set-Aside Blog, MSP Litigation, MSP News on October 15, 2019
Posted by Jean S. Goldstein, JD, CMSP

Last week, the Ninth Circuit United States Court of Appeals issued an important decision involving the Centers for Medicare & Medicaid Services, and the California Insurance Guaranty Fund (CIGA) in Cal. Ins. Guarantee Ass’n v. Azar, Nos. 17-56526, 17-56528, 2019 U.S. App. LEXIS 30339 (9th Cir. Oct. 10, 2019). We last discussed this case in […] Continue