Category Archives: WCMSA

Blog, Legal/Legislative News, Medicare Secondary Payer News, WCMSA

The WCRC, the entity which reviews Workers’ Compensation Medicare Set-Asides (WCMSAs) for the Centers for Medicare & Medicaid Services (CMS) has issued the award to Capitol Bridge LLC, a government services firm with its headquarters in Arlington, Virginia. The award notice is as of September 1, 2017 and can be found here. Noteworthy of the award is that it is for …
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Blog, Medicare Jurisdiction, Medicare Secondary Payer News, WCMSA

The Centers for Medicare & Medicaid Services (CMS) issued an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide on July 31st, although the Reference Guide is dated July 10, 2017. There are several important changes to note within this new Reference Guide (the new Guide can be located here). We have listed the more noteworthy changes first: Updated Amended Review …
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Legal/Legislative News, Medicare Jurisdiction, Medicare Set Aside, WCMSA

There are two recent updates which may impact workers’ compensation payers looking to finalize and foreclose future medical expenses and which additionally may impact claims that involve a Medicare Set-Aside (MSA). I. Arizona Passes Bill 1332 Allowing for Full and Final Settlement of Workers’ Compensation Claims Senate Bill 1332, signed into law by Governor Ducey on May 8, 2017 which …
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Blog, Medicare Jurisdiction, Medicare Set Aside, WCMSA

The Centers for Medicare & Medicaid Services (CMS) has followed through on their previously announced intent to expand their Medicare Set-Aside (MSA) Re-Review process. For our prior blog on CMS’ January announcement that it intended to expand its re-review process in 2017, click here. For those that need a refresher on CMS’ MSA Re-Review process, where an MSA is submitted …
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Administration, Blog, LMSA, Medicare Set Aside, WCMSA

As a follow-up to our recent blogs regarding a change in the Workers’ Compensation Review Contractor (WCRC) and the new WCRC reviewing Liability Medicare Set-Asides (LMSAs), CMS has now released the official solicitation for the award. The solicitation can be found here, and our latest prior blog on this topic can be found here. The solicitation states that proposal bids are due …
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CMS Announces Intent to Enhance Re-Review Process in 2017

11 Jan 2017 Heather Sanderson No Comments

Blog, Medicare Set Aside, WCMSA

Yesterday, CMS issued an Alert which states the following (the alert can be found here): The Centers for Medicare & Medicaid Services recently revisited the task of reviewing its process for addressing requests for CMS to “re-review” otherwise approved Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) amounts. In Calendar year 2017, CMS expects to update its existing re-review process to address …
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Blog, Medicare Secondary Payer News, Medicare Set Aside, WCMSA

We recently blogged that CMS delayed the Workers’ Compensation Review Contractor (the entity that reviews Workers’ Compensation Medicare Set-Asides) award to the 2ndquarter of 2017, with the solicitation being released in the 1st quarter. For our prior blog, click here. CMS has now released their draft Request for Proposal (RFP) as well as draft Statement of Work (SOW) for the Contractor.  While it is …
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Blog, Medicare Set Aside, WCMSA

According to the Court of Appeals of North Carolina, a WCMSA was not considered a “countable resource” for purposes of determining a claimant’s Medicaid eligibility, Williford v. North Carolina Department of Health and Human Services, 2016 N.C. App. LEXIS 1163 (November 15, 2016). The basic facts of the case involve a 68-year-old widow (Ms. Williford), who suffered a work injury …
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Blog, Medicare Set Aside, WCMSA

Alvarenga v. Scope Industries, et. al., WCAB #ADJ8733556 involves a settled workers’ compensation case for which a petition was filed to set-aside a Compromise & Release (C&R) because of mutual mistake.   The purported mistake was that the Medicare Set Aside (MSA), prepared by the Employer’s vendor, Helios, required review and approval by the Centers for Medicare & Medicaid Services (CMS).  …
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CMS Issues RFP for New MSA Contractor (WCRC)

26 Feb 2016 Heather Sanderson No Comments

Blog, Medicare Jurisdiction, WCMSA

  On February 22nd, CMS issued a Request for Proposal (RFP) which invites bids for the contractor that reviews WCMSA submissions- also known as the Workers’ Compensation Review Contractor (WCRC).  The proposal due date is April 8, 2016 and the anticipated award date is June 20, 2016. The RFP can be found here. A new contractor reviewing WCMSA submissions could …
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