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...
CMS Must Now Share Medicare Advantage and Part D Info as Part of the “PAID Act”
President Trump just signed the PAID Act into law, as part of the “Further Continuing Appropriations Act, 2021, and Other Extensions Act.” This Act now requires Medicare to share Medicare...
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...