Category Archives: WCMSA

Administration, Blog, Legal/Legislative News, Medicare Set Aside, WCMSA

For numerous years, a slightly varied version of essentially the same proposed legislation regarding Workers’ Compensation Medicare Set-Asides (WCMSAs) continues to be re-introduced in Congress (hereinafter referred to as “MSA Bill”). Just last week, the MSA Bill was again introduced in the Senate. It is titled “Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act of 2018.” A copy of …
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Settlement Contingent Upon CMS Approval of WCMSA: Problematic?

08 May 2018 Heather Sanderson No Comments

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

A decision just issued out of the Third Circuit Court of Appeal in Louisiana demonstrates the various nuances and obstacles that may be present when entering into a workers’ compensation settlement contingent upon CMS approval of a WCMSA. In Ortega v. Cantu Servs., Inc. 2018 La. App. LEXIS 845 (May 2, 2018), the claimant, a Medicare beneficiary, settled her disputed …
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Blog, Medicare Set Aside, WCMSA

Version 2.7 of the Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide has been released as of March 19, 2018. It can be found here. The two minor changes are the following: An updated phone number for the Workers’ Compensation Review Contractor (WCRC). The new phone number is (833) 295-3773. See section 14.0 (pg. 51), Appendix 1 (pg. 61) and Appendix 5 (pg. 84). …
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Blog, Medicare Secondary Payer News, WCMSA

Yesterday, March 7th, the Centers for Medicare & Medicaid Services (CMS) conducted a webinar to discuss the transition of the new Workers’ Compensation Review Contractor (WCRC) from Provider Resources to Capitol Bridge LLC. Below is a summary of the relevant points of the webinar.  Timing of Transition: Capitol Bridge LLC will fully take over on March 19, 2018. New Contact Information: The …
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Blog, Medicare Set Aside, WCMSA

Click here to read the full announcement. The webinar is scheduled for Wednesday, March 7, 2018 at 1:00 pm ET.

Blog, Legal/Legislative News, LMSA, Medicare Conditional Payments, Medicare Set Aside, WCMSA

The United States District Court for the District of New Mexico has issued an interesting decision involving the uncertainty for the need of a Liability Medicare Set-Aside (LMSA) in a medical malpractice settlement involving a Medicare beneficiary. The case is captioned Silva v. Burwell, 2017 U.S. Dist. LEXIS 195032 (November 28, 2017). A copy of the decision can be found …
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Blog, LMSA, Medicare Secondary Payer News, Medicare Set Aside, WCMSA

Liability Medicare Set-Asides (LMSAs) and No-Fault Medicare Set-Asides (NFMSAs) Update – The Centers for Medicare and Medicaid Services (CMS) has been taking incremental steps recently to implement a review process for LMSAs and NFMSAs. Over the past year we saw a series of indications that CMS was looking to implement a review process.  The Request for Proposal (RFP) for the Workers’ Compensation …
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Blog, Medicare Set Aside, WCMSA

Back in November of 2016, we blogged regarding the Workers’ Compensation Review Contractor (WCRC) introducing more stringent requirements for CMS approval of a zero Workers’ Compensation Medicare Set-Aside (WCMSA). For a short period of time, the WCRC was requiring either a court order or treating physician statement to approve a zero MSA allocation. However, the WCRC retracted this policy just …
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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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