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Workers' Compensation Medicare Set-Aside (WCMSA)

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December 13, 2018

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…

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October 5, 2018

CMS releases new WCMSA Reference Guide and NGHP Section 111 User Guide

The Centers for Medicare and Medicaid Services (CMS) has updated both its Workers' Compensation Medicare Set-Aside (WCMSA) Reference Guide and its Non-Group Health Plan…

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August 14, 2018

Drug formularies continue to expand in workers’ comp systems

Balancing rising medical and pharmaceutical costs with appropriate and timely treatment for injured workers has been an ongoing struggle for workers’ compensation…

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June 29, 2018

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)…

Files
May 22, 2018

Arizona tweaks its "full & final" workers' comp settlement law - New law provides opportunities to settle workers' comp claims

Arizona Senate Bill 1100 provides unprecedented opportunities to settle workers' compensation claims in the state.

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May 9, 2018

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.

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April 18, 2018

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.

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April 12, 2018

CMS issues new regulations aimed at identifying and limiting potential opioid abuse

On April 2, 2018, C,S issued a final rule which updated regulations for Medicare Advantage Plans (MAP) and Medicare Part D programs.

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March 23, 2018

CMS releases WCMSA reference guide (Version 2.7)

The Centers for Medicare and Medicaid Services (CMS) has released its latest WCMSA Reference Guide (Version 2.7).

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March 8, 2018

WCMSA update: CMS holds WCRC transition webinar

On March 7, 2018, CMS held a transition webinar regarding its upcoming Workers’ Compensation Review Contractor (WCRC) transition.

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March 2, 2018

WCMSA update: New WCRC takes over March 19th – webinar set for March 7th

CMS has announced that its new Workers Compensation Review Contractor, Capitol Bridge, LLC will assume WCRC responsibilities on March 19, 2018. CMS is holding a…

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February 28, 2018

Medicare watch list: Staying ahead of the Medicare Secondary Payer compliance curve

As another new year settles in, we know at least one thing is certain: MSP compliance will continue to present formidable challenges for claims payers.

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December 19, 2017

CMS and opioid medications - Will CMS address opioids in 2018?

Currently, CMS takes a strict formulaic approach that will price all Medicare covered medication related to a claim at the present dosage and frequency for the “duration…

Bid
December 15, 2017

GAO denies WCRC bid protests

In response to CMS awarding the WCRC bid to Capitol Bridge, LLC, KEN Consulting Inc. and Arch System, LLC filed formal bid protests with the Government Accountability…

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November 20, 2017

The CMS WCMSA "Amended Review process" - New opportunity to reduce WCMSA allocations and settle claims

For years, the Centers for Medicare and Medicaid Services (CMS) has refused to consider medical evidence postdating the original submission date of a Workers’…

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