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
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
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
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
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
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
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
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
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
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