On October 5, 2020, CMS released version 3.2 of its Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide.

Medicare coverage is not limited to Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). Medicare Advantage Plans (Part C) are also an available option for Medicare beneficiaries.

I recently wrote about Section 111 Total Payment Obligation to Claimant (TPOC) reporting in bifurcated settlements.

Prescription drugs can make up a large part of a Medicare Set-Aside.  Since Medicare prices future prescription drugs using average wholesale price, the ultimate cost of the drugs through a pharmacy benefits manager (PBM) is often less than the average wholesale price.

Most workers’ compensation claims adjusters would agree that the best claim is a closed one. 

One of the most significant cost-drivers in MSAs can be surgeries.  In addition to CMS becoming more aggressive in allocating for surgeries, we have recently seen the costs of these procedures increase as well. 

At NBKL, we pride ourselves in our ability to take teamwork to the next level, and in a recent MSA case, we put this teamwork to the test.

The Medicare Secondary Payer Recovery Portal improvements were rolled out on July 13, 2020.

The Office of Management and Budget recently updated the timing for the release of the long-awaited proposed rule addressing liability, no-fault and workers’ compensation settlements.

Workers’ compensation COVID-19 exposure claims involving Medicare beneficiaries may need to be reported to the Benefits Coordination and Recovery Center under Section 111 mandatory reporting.