The Official Medicare Set Aside Blog And Information Resource

Acupuncture Is Coming Soon to an MSA Near You: CMS Issues Decision to Cover Acupuncture for Medicare Beneficiaries

CMS, Medicare, Medicare Set-Aside Blog, MSP News, Opioids on January 22, 2020
Posted by Jean S. Goldstein, JD, CMSP

Yesterday, CMS issued a decision to cover acupuncture for Medicare patients with chronic low back pain (cLBP) to some extent.  You may recall that CMS previously issued a proposed decision to cover acupuncture, as we discussed here on our blog.  CMS’ final coverage decision memo can be found here, and indicates that acupuncture for chronic […] Continue

CMS Issues Alert With a Reminder for Non-Group Health Plan Responsible Reporting Entities

Mandatory Insurer Reporting, Medicare, Medicare Set-Aside Blog, MSP News on November 22, 2019
Posted by Jean S. Goldstein, JD, CMSP

While the big news of this week was that the proposed rulemaking due dates for both the rule concerning civil money penalty provisions for Medicare Secondary Payer (MSP) reporting and the rule to address satisfying MSP obligations has been extended once again, CMS also issued an alert this week with an important reminder for Non-Group […] Continue

Update: Proposed Rulemaking Due Dates Pushed Out Again for Civil Money Penalty Provisions for MSP Reporting and for a Rule Addressing Satisfying MSP Obligations

Mandatory Insurer Reporting, Medicare, Medicare Set-Aside Blog, MSP News on November 20, 2019
Posted by Jean S. Goldstein, JD, CMSP

As we continue to monitor for guidance from CMS regarding Medicare Secondary Payer (MSP) compliance as related to workers’ compensation, liability and no-fault insurance claims, CMS has once again made two significant updates.  You may recall in December, 2018, we reported of two advanced notices of proposed rulemaking which were added to the Unified Agenda […] Continue

2019 Social Security and Medicare Trustees’ Reports Issued; Reports Sound Alarm (Again) as Depletion of Trust Fund is Imminent

Medicare, MSP News, Social Security on May 2, 2019
Posted by Jean S. Goldstein, JD, CMSP

Each year, the board of trustees of the Social Security Trust Fund and Medicare Trust Fund release reports to Congress providing an estimated projected financial outlook for the programs.  Last week both reports were released.  The 79th annual Social Security Report can be found here, and the 54th annual Medicare report can be found here.  […] Continue

At the Intersection of a Longshore Act Claim and a Medicare Secondary Payer Act Claim: Which Side Wins?

Medicare, MSP Litigation, MSP News on April 17, 2019
Posted by Jean S. Goldstein, JD, CMSP

An interesting case arose out of the United States Court of Appeals for the Ninth Circuit yesterday.  The case is Grimm v. Vortex Marine Constr., No. 18-15104, 2019 U.S. App. LEXIS 11035 (9th Cir. Apr. 16, 2019), and involves an intersection of the Longshore and Harbor Workers’ Compensation Act (LHWCA), and the Medicare Secondary Payer […] Continue