The Official Medicare Set Aside Blog And Information Resource

CMS Issues Updated Section 111 User Guide and Updated WCMSA Portal User Guide

CMS, Mandatory Insurer Reporting, Medicare Set-Asides on July 19, 2019
Posted by Jean S. Goldstein, JD

The Centers for Medicare and Medicaid Services (CMS) released two new updated guides earlier this month: an updated Section 111 Medicare Secondary Payer Reporting User Guide, and an updated Workers’ Compensation Medicare Set-Aside Portal User Guide.  Both of these guides contain very minor updates, which will not have a significant impact on the claims handling process.  […] Continue

CMS Issues Proposed Decision to Cover Acupuncture for Medicare Beneficiaries

CMS, Medicare Set-Asides, Opioids on July 16, 2019
Posted by Jean S. Goldstein, JD

Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued a proposed decision to cover acupuncture for Medicare patients with chronic low back pain (cLBP) who are enrolled participants either in clinical trials sponsored by the National Institutes of Health (NIH) or in CMS-approved studies.  Currently, acupuncture is not covered by Medicare.  You may recall […] Continue

CMS Issues Final Rule for Medicare Advantage and Part D Pricing

CMS, Medicare Advantage, Rx/Pharmacy on May 22, 2019
Posted by Jean S. Goldstein, JD

Last week, the Centers for Medicare and Medicaid Services (CMS) issued a final rule, (CMS-4180-F) impacting Medicare Advantage Plans (MAP) and Part D programs.  The rule aims to ensure that patients have greater transparency into the cost of prescription drugs, so that beneficiaries can compare options and also enables MAPs to negotiate better prices for […] Continue

Medicare Secondary Payer Recovery Portal Webinar Slides Available

CMS, Conditional Payments, Medicare Secondary Payer Recovery Portal on March 26, 2019
Posted by Jean S. Goldstein, JD

The slides from a recent webinar held by the Centers for Medicare and Medicaid Services (CMS) regarding the upcoming enhancement to the Medicare Secondary Payer Recovery Portal (MSPRP) allowing electronic payments are now available, and can be viewed here.  As we discussed recently here on our blog, Non-Group Health Plans (liability insurers (including self-insurers), no-fault […] Continue