The Official Medicare Set Aside Blog And Information Resource

Another MSP Case Invades a Jurisdiction: The Sixth… This Time.

Medicare Advantage, Medicare Set-Asides, MSP Litigation on July 19, 2018
Posted by Jean S. Goldstein, JD

Another Medicare Secondary Payer (MSP) case involving the well-known entities, MAO-MSO, Recovery II, LLC MSP Recovery, LLC and MSPA Claims 1, LLC (“Plaintiffs”) has arisen out of the Sixth Circuit.[1] (MAO-MSO Recovery II, LLC v. Progressive Corp., No. 1:17CV390, 2018 U.S. Dist. LEXIS 119046, (N.D. Ohio July 17, 2018).  This recent opinion is issued in […] Continue

Professional Administration: The Last Piece of the MSP Compliance Puzzle

CMS, Medicare Set-Asides, Professional Administration on June 26, 2018
Posted by Jean S. Goldstein, JD

It has been nearly one year since the Centers for Medicare & Medicaid Services (CMS) first released a revised Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide,[1] which addressed one of the lesser discussed topics in Medicare Secondary Payer (MSP) compliance: professional administration.  Specifically, the revised guide included the following statement: “[a]lthough beneficiaries may act as […] Continue

Senate Bill 3079, Legislation to Band-Aid the Medicare Set-Aside Process Has Been Introduced

Legislation, Medicare Set-Asides, MSP News on June 21, 2018
Posted by Jean S. Goldstein, JD

You may recall in 2014, Senators Portman and Nelson introduced a Senate Bill, “[t]o amend title XVIII of the Social Security Act to provide for the application of Medicare secondary payer rules to certain workers’ compensation settlement agreements and qualified Medicare set-aside provisions.”  However, the legislation failed and never made it out of the Committee on […] Continue

Arizona SB 1100 Impacts Full and Final Settlements of Accepted Claims

Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, State Regulations on May 17, 2018
Posted by Jean S. Goldstein, JD

Last month, Arizona Governor, Doug Ducey signed Senate Bill 1100 (SB 1100), which is a modification to the legislation allowing for full and final settlements.[1]  You may recall our initial blog on the ability to finally fully settle and close out a workers’ compensation claim in Arizona, under Senate Bill 1332 (SB 1332), as well […] Continue

New Nebraska Legislation Allows Parties to Determine How Medicare’s Interests Should be Considered in Certain Settlements

Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on April 26, 2018
Posted by Jean S. Goldstein, JD

The Centers for Medicare & Medicaid Services (CMS) through various Memorandums and guides, has clearly stated that “[w]hile there are no statutory or regulatory provisions requiring that a (Workers’ Compensation Medicare Set Aside) WCMSA proposal be submitted to CMS for review, submission of a WCMSA proposal is a recommended process.”  Of significant note, the word […] Continue

CMS Issues Updates for Medicare Advantage and Prescription Drug Benefit Program: Will it Affect Your WCMSA?

CMS, Medicare Advantage, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, Opioids on April 5, 2018
Posted by Jean S. Goldstein, JD

Earlier this week, CMS issued a policy change revising the Medicare Advantage Program (MAP) Part C regulations and Prescription Drug Benefit program (Part D).  The ultimate goal of the new policy is to ensure that individual’s treatment needs are met, while improving the quality of care and providing greater choices to MA enrollees.  The full […] Continue

Updated WCMSA Reference Guide Issued

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, WCRC on March 21, 2018
Posted by Jean S. Goldstein, JD

An updated Workers’ Compensation Medicare Set-Aside (WCMSA) reference guide has been issued.  The revised guide, version 2.7, can be found here. The revised WCMSA reference guide has two minor updates, which are: An updated phone number for the new Workers’ Compensation Review Contractor “WCRC” (1-833-295-3773 between 9am-5pm EST, Monday thru Friday); and A revised Confidentiality […] Continue

WCRC Transition to be Seamless and Promising

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, WCRC on March 7, 2018
Posted by Jean S. Goldstein, JD

CMS and Capitol Bridge LLC, the entity taking over as the new Workers’ Compensation Review Contractor (WCRC) held a webinar today regarding the planned WCRC transition.  CMS introduced Capitol Bridge, who categorically addressed concerns regarding the transition.  It was quite clearly stated that today’s webinar would not address any policy questions, but simply address transition […] Continue

Capitol Bridge WCRC Transition Planned for 03/19/18

CMS, CRC, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, WCRC on March 1, 2018
Posted by Jessica M. Wingenroth, JD

CMS has invited the industry to participate in a Transition Webinar on 03/07/18 at 1:00 PM ET to discuss the transition of the Workers’ Compensation Review Contractor (WCRC) from Provider Resources, Inc. to Capitol Bridge, LLC. Capitol Bridge will assume responsibility of the WCRC contract on 03/19/18. As you may recall from our prior reports, […] Continue

MSP Stakeholders Exempt from CMS Beneficiary Identifier Changes: Everything You Need to Know About New MBIs

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, Social Security on February 26, 2018
Posted by Katharine Rupp, JD

Earlier this month, CMS held an open-door forum regarding the impending initiative to remove Social Security numbers (SSN) from all Medicare cards. As we previously reported, this plan aims to generate a new Medicare Beneficiary Identifier (MBI) for over 150 million Medicare beneficiaries; both active and deceased beneficiaries. The MBI will replace all SSN based […] Continue