What Can a Practitioner Expect from the CMS Review Process?
The first step in getting a Medicare set aside (MSA) approved by the Centers for Medicare and Medicaid Services (CMS) is to consult with a qualified MSA professional, such as...
Did CMS Just End the Use of “Evidence Based” and “Non-Submit” Medicare Set-Asides?
On January 10, 2022, the Centers for Medicare and Medicaid Services (CMS) published Version 3.5 of the Workers Compensation Medicare Set-Aside Arrangement Reference Guide. Section 4.3 of the updated version...
The Top 5 Reasons CMS Will Issue a Development Request
Nothing is more frustrating than reaching a workers’ compensation settlement only to have it delayed by weeks or months due to problems with the Medicare Set Aside (MSA) submission. One...
What Criteria Does CMS Use When Reviewing an MSA?
According to the WCMSA Reference Guide, the Workers’ Compensation Review Contractor will consider the following factors in making a decision about the adequacy your Medicare Set Aside: • The past...
Is CMS Ever Going to Issue Regulations Governing Liability MSA’s?
This week, Medicare once again punted on releasing notice of proposed rulemaking for post-settlement medical care on liability claims. Medicare has been seriously hinting at implementing such regulations since December...
Will CMS Re-Review an Approved MSA?
Here is the latest content from our YouTube channel addressing the issue of re-review and amended review of an approved MSA. https://binged.it/2RcV4tu
Gregory Lisowski to Present at Greater Bridgeport Bar Association
Gregory Lisowski has been asked to speak on issues of Medicare Secondary Payer Compliance before the Greater Bridgeport Bar Association on February 7, 2020. The presentation will focus on the...
CMS Announces New Guidelines For Re-Review Of Previously Approved WCMSAs
In the WCMSA User Guide version 5.1 which was published on July 10, 2017, CMS finally expanded the circumstances under which they will consider a re-review of a previously approved...
The Use of Future Medical Cost Projections
Have you struggled with what it means to “consider Medicare’s interests” where your case does not fall within the CMS review thresholds. While CMS has not specifically defined how it...