Although our nation is currently focused on the COVID-19 pandemic, the opioid abuse epidemic continues to claim many lives.

Almost every Workers’ Compensation Medicare Set-Aside (WCMSA) includes future diagnostic imaging studies, usually x-rays and MRIs.

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. 

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.

While development letters (CMS letters asking for additional information for a submitted MSA) have slowed over the last several months, we are still seeing them, nonetheless. 

For those of us who have been doing Medicare Set-Asides for over a decade, CMS’ pricing of prescription drugs has been a difficult pill to swallow. 

Approval of Workers’ Compensation Medicare Set-Asides (WCMSA) by the Centers for Medicare and Medicaid Services (CMS) remains the “gold standard.”

Version 3.0 of the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide was published by Centers for Medicare and Medicaid Services (CMS) on October 10, 2019.