Next week, CMS will be holding a telephone call to discuss and answer questions regarding CMS’ new opioid policies for Medicare drug plans. CMS finalized new policies for the Part D plans to follow starting January 1, 2019. Through this initiative, CMS is seeking to strengthen and broaden its partnership with providers to address the […] Continue
On 01/15/19, the Centers for Medicare & Medicaid Services (CMS) opened a National Coverage Analysis (NCA) to complete a thorough review of the evidence to determine if acupuncture for chronic low back pain is reasonable and necessary under the Medicare program. The public comment period is open until 02/14/19, a proposed decision memo due date […] Continue
Earlier this week, the Centers for Medicare & Medicaid Services (CMS) issued a revised Workers’ Compensation Medicare Set-Aside (WCMSA) reference guide, which we first alerted our readers to here on our blog. Some of the changes found within the update guide addressed a few of the recent alarming CMS approval trends we have been tracking. […] Continue
An updated Workers’ Compensation Medicare Set-Aside Reference guide was issued today. The revised guide, version 2.9 can be found here. The updates in this guide are as follows: To eliminate issues around Development Letter and Alert templates auto populating with individual Regional Office (RO) reviewer names and direct phone numbers, these will now display the […] Continue
What would year end 2018 be without some additional news that may impact your claims? As our readers are likely aware, we are in a partial government shutdown, and on the surface, it may appear that many of us who deal with workers’ compensation claims will not be affected. However, you might be surprised how […] Continue
Starting January 5, 2019, the Centers for Medicare and Medicaid Services (CMS) will begin using the CDC’s “Table 1: Life Table for the total population: United States, 2015” for Workers’ Compensation Medicare Set Aside (WCMSA) life expectancy calculations. This means that for any WCMSA proposal received by CMS, or where any WCMSA case is reopened […] Continue
The Centers for Medicare & Medicaid Services (CMS) recently added an item to the Unified Agenda, which may have an impact on your claims. The Unified Agenda of Federal Regulatory and Deregulatory actions is a semiannual compilation of information about regulations under development by federal agencies published in the spring and fall. The item added […] Continue
In our last blog about structured settlements we reviewed the basics of what a structured settlement is and why you would want to structure a settlement. However, the benefits of structuring a settlement are best shown through real life examples. Below are three scenarios in which MEDVAL was able to provide creative settlement solutions utilizing […] Continue
Lyrica (pregabalin) is an analog of the neurotransmitter gamma-aminobutryic acid, or GABA. Within the brain and nervous system, GABA plays an important role in behavior, cognition and the body’s response to stressful situations. A deficiency in naturally-occurring levels of GABA has been linked to conditions such as schizophrenia, depression, anxiety and various sleep disorders. While […] Continue
An updated Workers’ Compensation Medicare Set-Aside (WCMSA) reference guide has been issued. The revised guide, version 2.8, can be found here. The revised WCMSA reference guide includes the following updates: Fields formerly labeled as “HICN” have been relabeled as “Medicare ID” and can accept either an Health Insurance Claim Number (HICN) or the new Medicare Beneficiary […] Continue