The Official Medicare Set Aside Blog And Information Resource

HHS Grants to Fight Opioid Addiction: How Could the Grants Impact Your MSA?

CMS, Medicare Set-Aside Blog, Opioids, Rx/Pharmacy on May 4, 2017 | Posted by Jean S. Goldstein, JD

Nationwide, states and workers’ compensation boards have been taking measures to curb the overprescribing and misuse of opioids and the crisis that has ensued as a result.  Nonetheless, opioid addiction continues to be a growing concern.  In an effort to help states combat the opioid epidemic, the U.S. Department of Health and Human Services (HHS) […] Continue

Guaranteeing the Uncertain: Reversions and the ROI on a Structured Annuity

CMS, Medicare Set-Aside Blog, Structured Settlements on April 3, 2017 | Posted by Laura Johnson

The concept of reversions is a topic that surfaces frequently in our structured settlement department.  These clauses can seem confusing, sometimes made more complicated by uncertain futures; however, they are actually straightforward with tangible benefits associated with them.  There are two primary questions we hear the most when clients are asking how they can recover […] Continue

MAO Recovery & Courts: Aggressively Pursuing Liens

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP Litigation, MSP News on March 17, 2017 | Posted by Jean S. Goldstein, JD

On Wednesday, in the second decision of its kind this month, the United States District Court, Southern District of Florida denied in part and granted in part a Motion to Dismiss in a Medicare Advantage Organization (MAO) Medicare Secondary Payer Act (MSPA) recovery claim. MSPA Claims 1, LLC, et al. v. Century Surety Company, No. […] Continue

SPARC Act/Part D Prescription Drug Reform Reintroduced. What Does It Mean for MSP Recovery?

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on February 24, 2017 | Posted by Jean S. Goldstein, JD

In September 2016, House Representative Bill 6120 known as the Secondary Payer Advancement, Reconciliation, and Clarification (SPARC) Act was first introduced to Congress.  The bill did not pass at that time, but was just recently reintroduced into the House of Representatives as HR 1122.  Text of the recent bill is not yet available. The bill […] Continue

WCRC RFP Due Date Revised, Again.

CMS, Medicare Set-Aside Blog, Medicare Set-Asides on February 10, 2017 | Posted by Jean S. Goldstein, JD

CMS just issued an additional amendment to the RFP for the WCMSA review contractor. The amendment published additional responses to questions by offerors, and also a change in the due date for proposals to 10:00 am February 15, 2017. The amendment to the solicitation can be found here. Stay tuned for more details. Continue

WCRC RFP Due Date Revised

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on January 20, 2017 | Posted by Jean S. Goldstein, JD

Yesterday, CMS issued an amendment to the RFP for the WCMSA review contractor. The amendment published responses to questions by offerors, and informed offerors that additional answers to questions will be released on January 25, 2017. The amendment also reflects a change in the due date for proposals, to 10:00 am February 8, 2017. The […] Continue

150 Million Medicare Health Insurance Claim Numbers to be Changed to New Medicare Beneficiary Identifier Numbers in 2018

CMS, Medicare Set-Aside Blog, MSP News on January 18, 2017 | Posted by Katharine Rupp, JD

On Tuesday January 17, 2017, CMS held a special open door forum to discuss the changes and impact of the SSNRI on Medicare Secondary Payer (MSP) stakeholders. Starting April 1st, 2018, CMS will be replacing all Social Security Number (SSN) based Health Insurance Claim Numbers (HICN) with Medicare Beneficiary Identifier (MBI) numbers. Over 150 million […] Continue

CMS Releases Updated NGHP User Guide

CMS, Mandatory Insurer Reporting, Medicare Set-Aside Blog, MSP News on January 9, 2017 | Posted by Jean S. Goldstein, JD

CMS updated their Non-Group Health Plan (NGHP) User Guide, and released version 5.2.  The updated guide can be found here. The only update to the guide is the change in thresholds for reporting certain cases with total payment obligation to the claimant (TPOC), as indicated in CMS’ recently issued alerts and as previously discussed here […] Continue

CMS Special Open Door Forum to be Held

CMS, MSP News on January 4, 2017 | Posted by Jean S. Goldstein, JD

Yesterday, CMS announced that it will hold a conference call, a Special Open Door Forum, on Tuesday, January 17, 2017 at 3:00 pm EST.  The call will allow Medicare Secondary Payer stakeholders to learn and ask questions about changes involving the Social Security Number Removal Initiative, in general and in the context of MSP reporting. […] Continue