The Official Medicare Set Aside Blog And Information Resource

Comment Period Closed for Section 111 Civil Money Penalties Proposed Rule

CMS, Mandatory Insurer Reporting, MSP News on April 22, 2020
Posted by Jean S. Goldstein, JD, CMSP

On Monday, the comment period for the Centers for Medicare & Medicaid’s (CMS) Section 111 Civil Money Penalties (CMPs) proposed rule closed.  Entities that are responsible for complying with Section 111 reporting, and subsequently which may be subject to CMPs are referred to as Responsible Reporting Entities (RREs).  These entities must provide specific data on […] Continue

Social Security Administration Field Offices Are Closing; Do You Have a Compliance Game Plan?

Compliance, Medicare Set-Aside Blog, MSP News, Social Security on March 20, 2020
Posted by Jean S. Goldstein, JD, CMSP

Earlier this week, in an effort to help reduce the exposure of outside activities for our at-risk population, the Social Security Administration (SSA) announced that local offices are now closed to the public for in-person service.  The press release can be found here.  Local offices will continue to provide critical services over the phone.  In […] Continue

Workers’ Compensation Board Says “No” to Medicare Hold Harmless Language in Settlement Agreements

Conditional Payments, Medicare Set-Aside Blog, MSP News on March 4, 2020
Posted by Jean S. Goldstein, JD, CMSP

On Monday, the New York State Workers’ Compensation Board issued a bulletin that announced that the Board would no longer approve Section 32 Waiver Agreements that required the claimant to indemnify and hold the Carrier harmless for any payment made by Medicare for treatment of claimant’s work-related injuries before the execution of the Agreement.  The […] Continue

Proposed Civil Money Penalties Rule for Medicare Reporting to be Released

Mandatory Insurer Reporting, Medicare Set-Aside Blog, MSP News on February 14, 2020
Posted by Jean S. Goldstein, JD, CMSP

The Medicare Medicaid SCHIP Extension Act of 2007 (MMSEA) imposed Mandatory Insurer Reporting obligations on all Responsible Reporting Entities (RREs) when enacted in 2009.  These mandatory requirements specifically imparted obligations on all RREs and required entities to provide the Centers for Medicare & Medicaid Services (CMS) with data on claims that involve Medicare beneficiaries.  Furthermore, […] Continue

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