The Official Medicare Set Aside Blog And Information Resource

NAMSAP Bulletin Provides a Sneak Peek into CMS’ LMSA Review Program

CMS, Liability, MSP News on August 13, 2018
Posted by Jean S. Goldstein, JD

Last week, the National Alliance of Medicare Set Aside Professionals (NAMSAP), through their Liability Medicare Set Aside (LMSA) Committee issued a special edition bulletin about LMSAs.  The bulletin described an April 16, 2018 meeting between NAMSAP members and the Centers for Medicare & Medicaid Services (CMS).  The informational bulletin, which is subject to change until […] Continue

Medicare Secondary Payer Portal (MSPRP) Overview Webinar Scheduled for August 16, 2018

CMS, Conditional Payments, MSP News on July 31, 2018
Posted by Jean S. Goldstein, JD

You may recall we recently advised that CMS released an updated Medicare Secondary Payer Recovery Portal (MSRP) user guide, with the intention of creating more efficient practices.  CMS will be hosting a webinar to present the benefits of using the MSPRP, as well presenting the newly available features.  The webinar will be held on August […] Continue

CMS Releases Updated Medicare Secondary Payer Recovery Portal User Guide Noting Enhancements to the Portal

CMS, Conditional Payments, MSP News on July 10, 2018
Posted by Jean S. Goldstein, JD

CMS recently released an updated Medicare Secondary Payer Recovery Portal (MSRP) user guide in the hopes to lead to some more efficient practices.  A summary of the updates is as follows:   To reduce the number of calls received by the BCRC regarding the status of case correspondence, a new read-only Letter Activity tab has […] 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

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

New WCMSA Reference Guide Issued

CMS, Medicare, Medicare Set-Asides, MSP News, Re-Review Process on August 1, 2017
Posted by Jean S. Goldstein, JD

As you may be aware, on July 10th, here on our blog we announced the quiet release of a change to CMS’ re-review process.  However, as we noted at that time, this process was not formalized by CMS, and had simply been released through CMS’ Workers’ Compensation Medicare Set-Aside Portal (WCMSAP).  Specifically, through a revised WCMSAP User Guide, […] Continue

Endo Pharmaceuticals Voluntarily Withdraws Opana ER From the Market: What Does This Mean For Your Cases?

CMS, Medicare Set-Aside Blog, MSP News, Opioids, Re-Review Process on July 11, 2017
Posted by Erin O'Neill, PA-C, JD

On July 6, 2017, Endo Pharmaceuticals issued a statement indicating it would voluntarily withdraw the opioid pain medication, Opana ER, from the market, in response to the Food and Drug Administration’s request one month earlier. As noted in our prior blog post, the FDA requested that Endo Pharmaceuticals withdraw Opana ER from the market, citing concerns of […] 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

THE UR/IMR PROCESS: STILL GOOD ON ITS FACE.

CMS, Independent Medical Review, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, Work Comp on June 21, 2017
Posted by Jean S. Goldstein, JD

The California Supreme Court has determined that it will not review a case involving an injured worker who asserted that the Independent Medical Review (IMR) process was unconstitutional.  This is good news for California payers, furthering the defensive position that payers can continue to rely on both the Utilization Review (UR) and Independent Medical Review […] Continue

Countdown to October – Are You Ready for LMSAs and NFMSAs?   

CMS, Liability, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on June 5, 2017
Posted by Jennifer Alvarez, JD, RN, MSCC, CMSP

We are currently four months away from CMS implementing their new workflows for Medicare Administrative Contractors (MACs), which outline how they will handle bills when there is a Liability Insurance Medicare Set-Aside Arrangement (LMSA) or No-Fault Insurance Medicare Set-Aside Arrangement (NFMSA) involved in the settlement.  You may be aware that, in February 2017, CMS took […] Continue