Workers' Compensation Medicare Set-Aside (WCMSA)

Ibrahim Rifath 789914 Unsplash
October 27, 2016

CMS news alert: Zero allocations are far from over

The Centers for Medicare and Medicaid Services (CMS) made news this week by purportedly “correcting” their position on zero allocations.

September 16, 2016

Should you purchase MSA liability insurance?

Medicare Set-Asides (MSAs) are primarily a coordination of benefits tool. The failure to obtain & adequately fund an MSA can result in a denial of payment.

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September 13, 2016

New WCRC contract bid could indicate expansion of MSAs beyond workers' compensation

On September 6, the Centers for Medicare and Medicaid Services (CMS) updated a previously released pre solicitation notice.

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June 21, 2016

Will CMS expand MSA reviews to liability cases and other claims?

On June 9, the Centers for Medicare and Medicaid Services (CMS) announced that it is considering expanding its voluntary Medicare Set-Aside (MSA).

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September 22, 2015

A guide to the Office of Workers’ Compensation Programs (OWCP) fee schedule

Medicare Set-Asides (MSAs) are generally priced using the state fee schedule for the jurisdiction of the claim. However, it’s critical to distinguish an important group…

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July 29, 2015

Medication trends to watch

It’s no surprise that prescription medications are often the biggest cost driver in a Medicare Set-Aside (MSA).

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July 29, 2015

Impact of utilization review on Medicare Set-Asides

Although Utilization Reviews (URs) and Independent Medical Reviews (IMRs) have been used in state jurisdictions for years, insurers have only recently focused on how the…

Prescription Bottles Crop
June 22, 2015

FDA approves generic Abilify: Potential impact on Medicare set-asides

On April 25, 2015, the FDA issued approval for multiple manufacturers to market generic aripiprazole (Abilify).

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May 19, 2015

California’s independent medical review: Pursuing necessary and appropriate care

California uses Independent Medical Reviews (IMRs) to resolve disputes regarding medical treatment for injured employees. This process was enacted by way of a landmark…

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March 25, 2015

Medicare set-aside update: Generic Nexium and its impact on MSAs

On January 26, 2015, the FDA approved esomeprazole, the generic form of Nexium. Claims payers and the Medicare Set-Aside (MSA) industry take notice any time a widely…

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February 18, 2015

Preparing for mediation: Medicare checklist for WC claims

It is no secret that Medicare Secondary Payer compliance continues to complicate workers' compensation claims practice. Unfortunately, far too often Medicare issues…

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November 17, 2014

When can I use my WCMSA?

In McCarroll v. Livingston Parish Council, 2014 WL 5439624, -- So.3d – (La. App. 1st Cir., October 27, 2014), the parties believed that the claimant could use his…

November 17, 2014

Court rules that employer does not have to fund higher WCMSA amount

In Hunter v. Rapides Parish School Board, No. 14-490, 2014 WL 5669206 (La. App. 3rd , Nov. 5, 2014), the Louisiana appeals court held that the employer was not required…

Cms Claims
October 14, 2014

CMS withdraws its 'future medicals' notice of proposed rulemaking

Last week the Centers for Medicare and Medicaid Services (CMS) withdrew its Notice of Proposed Rulemaking (NPRM) for “future medicals” proposals for liability and…

Cms Approves Backlog Of Older Wcmsa Proposals
January 25, 2013

CMS approves backlog of older WC-MSA proposals

In December 2012, the Centers for Medicare and Medicaid Services (CMS) approved a substantial backlog of older workers' compensation Medicare Set Aside (WC-MSA)…