The Official Medicare Set Aside Blog And Information Resource

New CRC Contractor: What Are Our First Impressions?

Conditional Payments, CRC, Medicare Set-Aside Blog, MSP News, WCRC on March 20, 2018
Posted by Jean S. Goldstein, JD

It’s been over a month since the anticipated transition of the Commercial Repayment Center (CRC) contractor from CGI Federal to Performant Recovery.  Our first impressions have all been positive.  As with all transitions to new government contractors, we of course had some reservations and concerns, but to date are encountering only positive experiences. Some quick […] Continue

Liberty Life Assurance Company of Boston Announces Exit from the Structured Settlement Annuity Market

Structured Settlements on January 19, 2018
Posted by Michele Zimmerman

Our structured settlement department received word this morning that Liberty Life Assurance Company of Boston is being sold to Lincoln Financial Group. As a result of the sale, Liberty Life will be discontinuing the sale of structured settlement annuities.  This news comes on the back of their exit from the non-qualified structured settlements market.  While […] Continue

Another Court Case, Perpetuating the Confusion Surrounding LMSAs

CMS, Liability, Medicare Set-Aside Blog, MSP Litigation on November 29, 2017
Posted by Jean S. Goldstein, JD

Yesterday, a decision came out of the District Court for New Mexico, based upon an action to determine whether a Medicare Set-Aside was needed in a matter involving a personal injury suit.  (Silva v. Burwell, No. 16-cv-488 JCH/KK, 2017 U.S. Dist. LEXIS 195032, (D.N.M. Nov. 28, 2017).)  The applicability of the Medicare Secondary Payer act […] Continue

A portent of things to come? CMS releases revised WCRC contract pre-solicitation

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides, News and Events on April 19, 2016
Posted by Kimberly Wiswell

CMS has revised their pre-solicitation for the WCRC contract with the following statement: ATTENTION: RFP-CMS-2016-8A-0008 PRE-SOLICITATION notice has been updated as follows. The Centers for Medicare and Medicaid Services (CMS) has adjusted the referenced solicitation for the Workers’ Compensation Review Contractor (WCRC) due to updates that are currently being made to the Statement of Work (SOW) […] Continue

Will the Supreme Court Help Us Figure Out What Will Happen When MSA Funds are Improperly Spent?

Commentary, Medicare Set-Asides, News and Events on November 9, 2015
Posted by Jennifer Jordan, JD, MSCC

Theoretically CMS is supposed to deny related Medicare payments until such a time that it can be proven that an MSA was properly exhausted on related medical treatment. It is then that the question arises as to what will happen if the Claimant used the money and can’t pay for this own medical expenses. Our […] Continue

Management of Opioid Induced Hyperalgesia – The Impact on Workers’ Compensation Claims

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, Rx/Pharmacy, Work Comp on November 9, 2015
Posted by Abidemi Oyebode, R.Ph., MBA - Clinical Pharmacist

The impact of opioid use in workers’ compensation claims has been widely researched and the shocking results continue to reveal that opioid use remains a very significant concern for workers’ compensation carriers. As evidenced by the NCCI Workers’ Compensation Prescription Drug Study: 2013 Update, the average narcotic cost per claim continued to increase as did […] Continue

CMS Will Not Finalize the Draft Lower Limb Prostheses Local Coverage Determination DL33787

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, Work Comp on November 4, 2015
Posted by Erin O'Neill, PA-C, JD

On November 2, 2015, the Centers for Medicare and Medicaid Services (CMS) announced that the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) will not finalize the draft Lower Limb Prostheses Local Coverage Determination (LCD) DL 33787 at this time. This decision comes after a severe backlash from numerous stakeholder organizations regarding the proposed LCD. […] Continue

MEDVAL to Attend the National Workers’ Compensation & Disability Conference & Expo

Medicare Set-Aside Blog, MEDVAL News, Work Comp on October 29, 2015
Posted by Kimberly Wiswell

An estimated 2,000 plus participants are expected to attend the National Workers’ Compensation and Disability Conference & Expo (NWCDC) in Las Vegas next month. In its 24th year, this is the leading event for workers’ compensation and disability management professionals. MEDVAL is pleased to be both an exhibitor and event sponsor. We invite you to […] Continue

Florida PIP Carriers Beware of a Potential Increase in MSP Reimbursement Demands

Liability, Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation on September 11, 2015
Posted by Jennifer Jordan, JD, MSCC

On August 28, 2015, the US District Court or the Southern District of Florida granted yet another motion to dismiss a MSP private cause of action for failing to demonstrate responsibility to make payment sufficient to trigger the Medicare Secondary Payer Act.  While at first I found the opinion rather insignificant given that this is […] Continue

Medicare Trust Fund Exhaustion Pushed Back Until 2030

Medicare on July 28, 2014
Posted by Jennifer Jordan, JD, MSCC

In its Trustees Report released July 28, 2014, CMS announced that the Medicare trust fund will remain solvent until 2030, four more years than previously projected, due in part to cost controls implemented in the Affordable Care Act. Factors that contributed to the improved outlook included lower than expected spending in 2013 and decreased overall […] Continue