The Official Medicare Set Aside Blog And Information Resource

Update: Proposed Rulemaking to Clarify Existing MSP Obligations

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSAs, MSP News on July 1, 2020
Posted by Jean S. Goldstein, JD, CMSP

We continue to monitor guidance from the Centers for Medicare & Medicaid Service (CMS) regarding Medicare Secondary Payer (MSP) compliance as related to workers’ compensation, liability, and no-fault insurance claims.  As we often discuss here on our blog, CMS continues to place emphasis on satisfying MSP obligations.  You may recall that in December 2018, CMS […] Continue

Significant Price Changes for Meloxicam & Benefits to Your WCMSAs

Medicare Set-Aside Blog, MSAs, Rx/Pharmacy on April 2, 2020
Posted by Jean S. Goldstein, JD, CMSP

Mobic (meloxicam) is a nonsteroidal anti-inflammatory drug (NSAID) commonly seen in workers’ compensation claims.  It is most frequently prescribed to treat osteoarthritis (OA) starting at doses of 7.5 mg and may be increased to 15 mg daily to reduce pain, joint swelling, and stiffness in joints. Recently, the average wholesale price of this medication dropped […] Continue

Reminder: 04/01 Revised CMS Release Must be Used; Electronic Signatures: OK

CMS, MSAs, WCRC on March 23, 2020
Posted by Jean S. Goldstein, JD, CMSP

In just 9 days, the Centers for Medicare & Medicaid Services (CMS) will no longer accept a standard CMS release when submitting a Workers’ Compensation Medicare Set-Aside (WCMSA) for review and approval to the Workers’ Compensation Review Contractor, CMS’ independent contractor.   As noted in CMS’ most recently issued WCMSA Reference Guide, beginning on April 1, […] Continue

CMS to Begin Utilizing 2017 Life Table

CMS, Medicare Set-Aside Blog, MSAs, WCRC on March 18, 2020
Posted by Jean S. Goldstein, JD, CMSP

Starting April 25, the Centers for Medicare and Medicaid Services (CMS) will begin using the Center for Disease Control’s (CDC) “Table 1: Life Table for the total population: United States, 2017” for Workers’ Compensation Medicare Set Aside (WCMSA) life expectancy calculations.  This means that for any WCMSA proposal received by CMS through the voluntary review […] Continue

State-Imposed Restrictions on Gabapentin

Medicare Set-Aside Blog, MSAs, Rx/Pharmacy on January 8, 2020
Posted by Leah King, PharmD, JD, Independent Pharmacy Consultant

In recent years, we have seen a growing number of instances where federal law and state law are not in perfect alignment with regard to certain medications. As one example, we’ve seen a number of states pass laws allowing for the medical and/or recreational use of marijuana compounds even though marijuana is classified as a […] Continue