CMS Reduces MSP Liability Threshold for 2017 to $750

05 Dec 2016 Heather Sanderson No Comments

Blog, LMSA, Medicare Secondary Payer News, Medicare Set Aside

Yesterday, CMS announced that the threshold for liability settlements will reduce to $750. CMS will also maintain the $750 threshold for no-fault and workers’ compensation settlements, where the no-fault insurer or workers’ compensation entity does not otherwise have ongoing responsibility for medicals. To read CMS’ Alert click here. For CMS’ methodology in determining its 2017 thresholds, click here. Recall that …
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Blog, Medicare Jurisdiction, Medicare Secondary Payer News

A few months ago, we issued a blog regarding MSP private cause of action litigation against a Plaintiff attorney law firm for failure to reimburse the MAP its conditional payments (Humana v. Paris Blank LLP). For our prior blog on this case, click here. The Paris Blank matter has now settled and the parties are subject to a confidentiality provision.  …
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CMS Rescinds Recent Changes to Review of Zero Allocations

04 Nov 2016 Heather Sanderson No Comments

Blog, Legal/Legislative News, Medicare Set Aside

Last week, the Workers’ Compensation Review Contractor (WCRC) informally let the industry know that an internal quality review revealed that the WCRC was improperly applying CMS’ documentation requirements to the review of zero allocations in denied worker’s compensation claims. As such, additional documentation would now be required for the WCRC to issue an approval of a zero Medicare Set-Aside (MSA) …
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Blog, Medicare Set Aside

The MSA industry has been abuzz, and Franco Signor has confirmed with the Workers’ Compensation Review Contractor (WCRC), that changes are being made to the requirements for CMS to approve zero allocations based upon denial of the workers’ compensation claim. We have been informed that these corrections will be outlined in a policy memo soon, but that some of the …
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Blog, Legal/Legislative News

With the Presidential Elections on November 8th nearing around the corner, the industry has been wondering how the election of either Hillary Clinton or Donald Trump as President of the United States would affect Medicare Secondary Payer (MSP) Act compliance. *Note that this blog is not intended to be an endorsement for either political candidate, political party, platform, or affiliation. …
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Blog, Medicaid Third Party Liability Recoveries

Medicaid Third Party Liability Background Medicaid is similar to Medicare in that it is a government program that provides health care benefits to certain groups of people; however it is different in that it is a needs based program, whereas Medicare is entitlement based (generally based upon being at least 65 years of age and/or disabled). With Medicaid, individuals must …
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