The Official Medicare Set Aside Blog And Information Resource

CMS Targets Medical Providers and “Other Interested Stakeholders” in Upcoming Part D Opioid Overutilization Policies Call

CMS, Medicare Set-Asides, Opioids on February 7, 2019
Posted by Jean S. Goldstein, JD, CMSP

Next week, CMS will be holding a telephone call to discuss and answer questions regarding CMS’ new opioid policies for Medicare drug plans.  CMS finalized new policies for the Part D plans to follow starting January 1, 2019.  Through this initiative, CMS is seeking to strengthen and broaden its partnership with providers to address the […] Continue

Updated Guides Issued: WCMSA Reference Guide and Section 111 Reporting Guide

CMS, Medicare Set-Asides, MSP News on October 4, 2018
Posted by Jean S. Goldstein, JD, CMSP

An updated Workers’ Compensation Medicare Set-Aside (WCMSA) reference guide has been issued.  The revised guide, version 2.8, can be found here. The revised WCMSA reference guide includes the following updates: Fields formerly labeled as “HICN” have been relabeled as “Medicare ID” and can accept either an Health Insurance Claim Number (HICN) or the new Medicare Beneficiary […] 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, CMSP

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

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, CMSP

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

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