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...
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...
MSA SERVICES, LLC ANNOUNCES SETTLEMENT CONSULTING
MSA Services, LLC offers a variety of services to assist both personal injury attorneys and insurance adjusters in the pre- and post-settlement process. Our settlement consulting team provides access to...
9th Circuit Holds Guarantee Association not a Primary Payer Under MSP
In the case of California Insurance Guarantee Association v. Azar, the 9th Circuit Court of Appeal recently held that a Guarantee Fund is not a “primary plan” under the Medicare...
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...
CMS Signals Use of LMSAs In 2017
Over the past few weeks, the Centers for Medicare and Medicaid Services (CMS) has strongly signaled that it will begin taking steps to enforce the Medicare Secondary Payer (MSP) Act...