Making Sense of the WCMSA Reference Guide 2.6

When the Centers for Medicare and Medicaid Services (CMS) released the latest Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide on July 31, 2017, we anticipated more insights to new processes; but the new guide presents as many questions as it proposes to answer. Questions remain about how limits to WCMSA re-reviews will play out and […]

Amended Review and Other Takeaways from the Latest WCMSA Reference Guide

On July 31st 2017, the Centers for Medicare and Medicaid Services (CMS) released its most recent version of the Workers’ Compensation Medicare Set-Aside Reference Guide—and there’s a lot to digest. We received some clarification about how CMS will implement the new “Amended Review” option we wrote about previously. CMS also provided “clarifications” and changes for […]

Opana ER Will Be Removed from the Marketplace

Opana ER will be voluntarily removed from the marketplace, per the announcement last week of manufacturer Endo International plc. This follows the FDA’s suggestion that we blogged about last month—and it is an important next step in the fight against opioid abuse. No date has been set to remove the medication, but we’re closely monitoring […]

Break the Logjam of Zero MSAs in Development

Zero WCMSA submissions are getting mired in a cycle of CMS development letters and responses, as the CMS Workers’ Compensation Review Contractor (WCRC) becomes increasingly meticulous about formatting requirements for submitted pay histories. Many of the current WCRC reviewer requests are not even listed requirements in either the WCMSA reference guide or the CMS operating […]