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The MSA – A Nexus of Legal and Medical Interests

By |2020-11-03T10:54:46-05:00November 3rd, 2020|CMS, Government, MSA, Review Process|

Just as no two car crashes are the same, neither are two Workers’ Compensation cases (WC), especially when the need for a Medicare Set Aside (MSA) account is a possibility. To ensure the protection of the interests of both the injured worker and the Centers for Medicare and Medicaid Services (CMS) throughout the WC claim [...]

Making the Most of an MSA Amended Review Request

By |2020-04-01T12:00:18-04:00April 1st, 2020|Government, MSA, Review Process|

In 2017, when the Center for Medicare and Medicaid Services (CMS) updated its Medicare Set Aside (MSA) Reference Guide, it added a provision that allowed a one-time opportunity to request an ‘amended review' of a conditionally preapproved MSA account. When a case met the required elements of the new rule, claimants and carriers could re-submit [...]

CMS Updates WCMSA Reference Guide

By |2019-12-06T13:19:13-05:00December 6th, 2019|Government, MSA, Review Process|

Everyone updates, including the Centers for Medicare and Medicaid Services (CMS). In October, the CMS released its updated Medicare Set Aside (MSA) reference guide, version 3.0, which replaces version 2.9 released just in January of this year. As participants in the MSA system make changes to reflect the new guidelines, they should be careful to [...]

Two Bills Favor MSA Appeals Restructure

By |2018-08-29T11:23:57-04:00August 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 [...]

Nebraska Revises WCMSA Approval Process

By |2018-05-31T12:23:00-04:00May 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 [...]

Looking Ahead to 2018

By |2018-01-03T15:32:28-05:00January 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 [...]

Meet the Newest CMS WCRC Contractor

By |2017-10-31T14:20:14-04:00October 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 [...]

CMS Revisions Permit Amended Reviews for MSA

By |2017-07-17T12:16:55-04:00July 17th, 2017|MSA, Review Process, Settlement|

For the first time, parties involved in a Workers' Compensation Medicare Set-Aside (WCMSA) can request a re-review of the MSA value when they dispute the CMS determination or when the financial circumstances of medical care vary from the approved MSA amount by ten percent or $10,000. In the past, insurers, corporations, and injured persons had [...]