The Official Medicare Set Aside Blog And Information Resource

CMS Considering Voluntary Review of Liability MSAs, Again

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on October 26, 2017 | Posted by Jean S. Goldstein, JD

On October 26, CMS once again issued an alert indicating it would be considering expanding the review of voluntary Medicare Set-Asides (MSAs) to include liability insurance and no-fault insurance (LMSAs and NFMSAs).  Just as with other alerts, today’s alert also states that CMS will work closely with the stakeholder community to identify how best to […] Continue

Countdown to October – Are You Ready for LMSAs and NFMSAs?   

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on June 5, 2017 | Posted by Jennifer Alvarez, JD, RN, MSCC, CMSP

We are currently four months away from CMS implementing their new workflows for Medicare Administrative Contractors (MACs), which outline how they will handle bills when there is a Liability Insurance Medicare Set-Aside Arrangement (LMSA) or No-Fault Insurance Medicare Set-Aside Arrangement (NFMSA) involved in the settlement.  You may be aware that, in February 2017, CMS took […] Continue

Update: CMS Review Contractor Solicitation and Award Date Delayed

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides, News and Events on October 6, 2016 | Posted by Jean S. Goldstein, JD

As you know, we have been anticipating the release of CMS’ final solicitation for bids for an RFP for the Workers’ Compensation Review Contractor (WCRC) to review WCMSA proposals.  The pre-solicitation bid was to be released on September 22, 2016.  However, September 22, came and went without the release of the solicitation.  We finally received […] Continue

CMS Issues Revised and Modified Pre-Solicitation Notice

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides, News and Events on September 7, 2016 | Posted by Jean S. Goldstein, JD

We have been reporting over the last several months that CMS was soliciting bids for an RFP for the Workers’ Compensation Review Contractor (WCRC), to review WCMSA proposals.  We have been anxiously awaiting CMS’ revised and modified pre-solicitation notice, which was previously scheduled to be out in June.  Well, today, it’s finally out.  The pre-solicitation […] Continue

Finally, June 27

CMS, Liability, Medicare Set-Aside Blog on June 27, 2016 | Posted by Jean S. Goldstein, JD

Today is June 27, the first day indicated by CMS as the target date CMS anticipated releasing the adjusted solicitation for the new Workers’ Compensation Review Contractor (WCRC).  We, at MEDVAL, are eagerly awaiting the revised solicitation to determine if in fact the new solicitation will reflect the review of liability MSAs.  We are sitting […] Continue

CMS Announces LMSA Review Program

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides on June 10, 2016 | Posted by Jean S. Goldstein, JD

On June 9, 2016, CMS officially validated rumors that it is in fact considering reviewing LMSAs. Announcement of the proposal and subsequent town hall meetings are expected later in the year. The alert (which can be found here) indicated that CMS is considering expanding its voluntary Medicare Set-Aside Arrangements (MSA) amount review process to include […] Continue

A portent of things to come? CMS releases revised WCRC contract pre-solicitation

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides, News and Events on April 19, 2016 | Posted by Kimberly Wiswell, CMSP

CMS has revised their pre-solicitation for the WCRC contract with the following statement: ATTENTION: RFP-CMS-2016-8A-0008 PRE-SOLICITATION notice has been updated as follows. The Centers for Medicare and Medicaid Services (CMS) has adjusted the referenced solicitation for the Workers’ Compensation Review Contractor (WCRC) due to updates that are currently being made to the Statement of Work (SOW) […] Continue

Medicare Recovers Despite Failure to Treat Being the Claim

CMS, Commentary, Liability, Medicare, Medicare Set-Aside Blog, MSP Litigation on March 4, 2016 | Posted by Jennifer Jordan, JD, MSCC

Alleging medical damages and receiving compensation for release from liability for those same medical damages will result in reimbursing Medicare for related medical expenses pretty much regardless of your legal theory as to why you should keep that windfall rather than the federal government. On March 3, 2016, the U.S. District Court for the Eastern […] Continue

Another Case Filed by MSP Recovery for Double Damages Pursuant to Medicare Secondary Payer Act Dismissed for Failure to Demonstrate Payment Obligation

Liability, Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation on October 5, 2015 | Posted by Joanna Wynes, JD

In MSP Recovery v. Allstate Ins. Co., 2015 U.S. Dist. LEXIS 1380834 (S.D. Fla. Sept. 22, 2015), the United States District Court for the Southern District of Florida dismissed yet another claim filed by, inter alia, John Ruiz, Esquire of La Ley Law firm on behalf of MSP Recovery against another personal injury protection (PIP) […] Continue

Tennessee PIP/MAO Private Cause of Action Scheduled for Trial in September 2016

Liability, Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation on September 24, 2015 | Posted by Jennifer Jordan, JD, MSCC

Yet another action by a Medicare Advantage Organization seeking recovery from a PIP carrier has been reported out of Tennessee. In this case, Cariten Health Plan is seeking reimbursement of $15,799 paid, out of $55,378.70 billed, on behalf of a Medicare Advantage beneficiary who had PIP coverage through Mid-Century Insurance, a Farmers subsidiary, at the […] Continue