The Official Medicare Set Aside Blog And Information Resource

Inclusion of Lyrica in Workers’ Compensation Medicare Set-Aside Arrangements

Medicare Set-Asides, Rx/Pharmacy, WCRC on October 11, 2018
Posted by Complex Claims Division

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

Updated WCMSA Reference Guide Issued

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, WCRC on March 21, 2018
Posted by Jean S. Goldstein, JD

An updated Workers’ Compensation Medicare Set-Aside (WCMSA) reference guide has been issued.  The revised guide, version 2.7, can be found here. The revised WCMSA reference guide has two minor updates, which are: An updated phone number for the new Workers’ Compensation Review Contractor “WCRC” (1-833-295-3773 between 9am-5pm EST, Monday thru Friday); and A revised Confidentiality […] Continue

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

WCRC Transition to be Seamless and Promising

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, WCRC on March 7, 2018
Posted by Jean S. Goldstein, JD

CMS and Capitol Bridge LLC, the entity taking over as the new Workers’ Compensation Review Contractor (WCRC) held a webinar today regarding the planned WCRC transition.  CMS introduced Capitol Bridge, who categorically addressed concerns regarding the transition.  It was quite clearly stated that today’s webinar would not address any policy questions, but simply address transition […] Continue

Capitol Bridge WCRC Transition Planned for 03/19/18

CMS, CRC, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, WCRC on March 1, 2018
Posted by Jessica M. Wingenroth, JD

CMS has invited the industry to participate in a Transition Webinar on 03/07/18 at 1:00 PM ET to discuss the transition of the Workers’ Compensation Review Contractor (WCRC) from Provider Resources, Inc. to Capitol Bridge, LLC. Capitol Bridge will assume responsibility of the WCRC contract on 03/19/18. As you may recall from our prior reports, […] Continue

WCRC Award Protests Denied

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, WCRC on December 18, 2017
Posted by Jean S. Goldstein, JD

As we previously reported, CMS awarded the Workers’ Compensation Review Contractor (WCRC) contract to Capitol Bridge, LLC, which was subsequently protested by two other companies who participated in the bidding process.  The protests were recently denied, but the decisions are covered by protective orders and must be redacted before being published.  Once available, the decisions […] Continue

NEW Workers’ Compensation Review Contractor (WCRC) Contract Awarded

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, WCRC on September 5, 2017
Posted by Jean S. Goldstein, JD

Finally, a new Workers’ Compensation Review Contractor (WCRC) award has been issued.  This news comes after several months of work being completed by Provider Resources, the incumbent contractor, under an expired contract.  The new WCRC contract was awarded on September 1, 2017 to Capitol Bridge, LLC of Arlington, Virginia, a certified small business entity.  Capitol […] Continue

Eyes on the Prize: A New CMS Re-Review Option is Available.

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, WCRC on July 10, 2017
Posted by Jean S. Goldstein, JD

While all eyes (and ears) have been focused on the news, or the lack thereof of news regarding the Workers’ Compensation Review Contractor award, CMS quietly released a change to their re-review process today.  The change was released through CMS’ Workers’ Compensation Medicare Set-Aside Portal (WCMSAP).  Specifically, through a revised WCMSAP User Guide, which can […] Continue

Will the WCRC Award Be Announced Tomorrow?

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, WCRC on June 29, 2017
Posted by Jean S. Goldstein, JD

Tomorrow is June 30.  Per the Centers for Medicare & Medicaid Services (CMS), we are expecting that the Workers’ Compensation Review Contractor (WCRC) award will be announced tomorrow.  The WCRC is the entity responsible for projecting future medical costs that would otherwise be reimbursable by Medicare, for those cases submitted as related to a workers’ […] Continue