MSA

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Governments and Opioids

By |2018-10-31T12:10:27+00:00October 31st, 2018|CMS, Government, Opioid Series, Opioids|

Across the country, governments of all types are looking at how the opioid crisis is affecting their regions and communities. Both the federal Administration and Congress have issued new rules at the national level that reflect their cognizance of the concern and its causes. States, too, are addressing how their systems manage the crisis, including [...]

Two Bills Favor MSA Appeals Restructure

By |2018-08-29T11:23:57+00:00August 29th, 2018|MSA, Review Process|

If Congress passes one or both of two bills presently sitting in congressional committees, then parties to a workers’ compensation (WC) case may finally have a solution to a problem that has plagued that system since its inception. Each of the two proposed bills originates in the separate chambers, and both appear to share a [...]

Evolving CMS Controls on Opioid Prescriptions

By |2018-08-01T10:32:46+00:00August 1st, 2018|CMS, MSA, Opioids|

Despite notable guidance available in other arenas, more than two thirds (69.4%) of California's submitted WCMSA proposals include extended funding for opioid medications. The statistic is startling considering that Medicare itself does not recommend using opioids for long-term use or chronic pain. The National Alliance of Medicare Set-Aside Professionals (NAMSAP) and the National Council of [...]

AZ SB 1100 – Speeding the Process of Settlement

By |2018-06-28T10:16:03+00:00June 28th, 2018|MSA, Settlement|

Arizona has taken a step toward fully resolving the medical coverage uncertainties that linger when its workers suffer injuries on the job. While many workers’ compensation (WC) injuries resolve relatively quickly, others take longer to respond to treatment in both the acute and post-acute phases, resulting in an extended recovery period and higher healthcare costs [...]

Nebraska Revises WCMSA Approval Process

By |2018-05-31T12:23:00+00:00May 31st, 2018|CMS, MSA, Review Process, Settlement|

The Mandatory Second Payer Act (MSP) prohibits the Centers for Medicare and Medicaid Services (CMS or Medicare) from making injury-related payments for Medicare beneficiaries if there's another carrier or provider with a primary obligation to do so. When working to settle an injury claim by a Medicare beneficiary, the parties to the case must take [...]

Accounting for MSA Drug Price Hikes

By |2018-03-29T13:46:34+00:00March 29th, 2018|MSA, Opioids|

In almost all Workers’ Compensation (WC) cases, the Medicare Set-Aside account (MSA) includes a certain percentage of funding to cover the pharmaceutical expenses that are involved in many recovery protocols. MSAs related to more significant injuries such as loss of limbs or temporary or permanent disabilities often reserve the highest financial value specifically for drugs [...]

CMS Offers Narrow Exception for State Laws

By |2018-03-01T13:17:39+00:00March 1st, 2018|CMS, MSA|

The Centers for Medicare and Medicaid Services (CMS) may be allowing an exception to the federal rule that asserts no state law will supersede its jurisdiction under any circumstances. An updated Reference Guide for Worker's Compensation Medicare Set-Aside Arrangements (WCMSA) version 2.6, suggests that CMS may be more willing than before to let state law [...]

Looking Ahead to 2018

By |2018-01-03T15:32:28+00:00January 3rd, 2018|CMS, CMS WCRC, MSA, Review Process|

On October 1, 2017, the Centers for Medicare and Medicaid Services (CMS) was scheduled to stop paying for health care services that should, instead, be covered by parties deemed responsible for those damages pursuant to liability and no-fault insurance cases. In early 2017, the agency had announced that Medicare-beneficiary claimants in both liability and no-fault [...]

CMS Proposes Opioid-Management Rules

By |2017-11-30T09:37:07+00:00November 30th, 2017|CMS, MSA, Opioids|

America is struggling to contain its nation-wide opioid epidemic, which has taken thousands of lives and crippled the lives of many thousands more. In mid-2016, President Obama signed the Comprehensive Addiction and Recovery Act (CARA), the first federal law designed to provide a comprehensive, balanced, and coordinated strategy to improve access to and treatment for [...]

Meet the Newest CMS WCRC Contractor

By |2017-10-31T14:20:14+00:00October 31st, 2017|CMS WCRC, MSA, Review Process|

There is a new Worker's Compensation Recovery Center WCRC contractor in place as of September 1, 2017. The new contractor is Capital Bridge LLC, headquartered in Arlington VA., which replaces Provider Resources Inc. (PRI). The contract award is notable for several reasons: It comes two months later than its announced date. Since early July, all [...]