Centers for Medicare and Medicaid Services (CMS)

CMS Will Use the 2015 CDC Life Table for WCMSAs Starting 1/5/19

In an alert dated December 5, 2018, the Centers for Medicare and Medicaid Services (CMS) announced that beginning January 5, 2019, they will use the new 2015 CDC Life Table to calculate adjusted li...

CMS Retains $750 “Low Dollar” Threshold for 2019

The Centers for Medicare and Medicaid Services (CMS) has released its low dollar recovery threshold for 2019 via an alert dated November 15, 2018. CMS is generally required to publish an annual low...

CMS Updates its Medicare Prescription Drug Benefit Manual – New Changes Encourage Part D Collection and Recovery

The Centers for Medicare and Medicaid Services (CMS) has amended its Medicare Prescription Drug Benefit Manual (Part D Manual) to add, in part, stronger language regarding Medicare Part D sponsors’...

CMS Releases New WCMSA Reference Guide and NGHP Section 111 User Guide

The Centers for Medicare and Medicaid Services (CMS) has updated its Workers' Compensation Medicare Set-Aside (WCMSA) Reference Guide and Non-Group Health Plan (NGHP) Section 111 User Guide . These...

CMS Hosts Medicare Secondary Payer Recovery Portal (MSPRP) Webinar

On August 16, 2018, the Centers for Medicare and Medicaid Services (CMS) hosted a webinar focusing on its Medicare Secondary Payer Recovery Portal (MSPRP). The MSPRP is CMS’ web-based application...

Minor changes in newly released Medicare Secondary Payer Recovery Portal User Guide

The Centers for Medicare and Medicaid Services (CMS) has released an updated version of its Medicare Secondary Payer Recovery Portal (MSPRP) User Guide (Version 4.2). The changes are minor and...

Workers’ Compensation Medicare Set Aside Legislation Filed, Referred to Committee

On June 18, 2018, Senators Rob Portman (R-OH) and Bill Nelson (D-FL) introduced legislation aimed at reforming the Centers for Medicare and Medicaid Services’ (CMS) Workers’ Compensation Medicare...

Five Steps to Reduce Your WCMSA Costs

It is no secret that high Workers’ Compensation Medicare Set Aside (WCMSA) allocation amounts can complicate claim settlement. The culprits can range from the Centers for Medicare and Medicaid...

New Kentucky Workers’ Compensation Law Limits Treatment to 780 Weeks for Certain Claims

On March 30, 2018, Kentucky House Bill (HB-2) was signed into law which makes major changes to the Kentucky workers’ compensation statute. The most significant addition is language that limits...

CMS Issues New Regulations Aimed at Identifying and Limiting Potential Opioid Abuse

On April 2, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a final rule which updated regulations for Medicare Advantage Plans (MAP) and Medicare Part D programs. The primary foc...