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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Blog, Legal/Legislative News, Medicare Jurisdiction, Medicare Secondary Payer News, Pharma Part D, Reimbursements

The Medicare Advocacy Recovery Coalition (MARC) worked diligently over the past eighteen months to develop and introduce the Secondary Payer Advancement, Rationalization and Clarification Act of 2016 (SPARC). Representatives Tim Murphy (18th District Pennsylvania, Republican) and Ron Kind (3rd District Wisconsin, Democrat) sponsored this bipartisan legislation that was immediately referred to the two committees of jurisdiction over Medicare – House …
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CMS Delays WCRC Award to 2nd Quarter of 2017

06 Oct 2016 Heather Sanderson No Comments

Medicare Jurisdiction, Medicare Secondary Payer News

Just last month, CMS issued an updated timeframe Request for Proposal (RFP) for a new Workers’ Compensation Review Contractor (WCRC) bid. This last update stated that the proposal would be released in October 2016, with an award being granted in February 2017. For our prior blog, click here. However, CMS has again updated/delayed their pre-solicitation notice to state that the solicitation …
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Blog, Legal/Legislative News, Medicare Reporting Section 111, TPOC

As required by section 202 of The SMART Act, CMS is required to annually review its costs relating to recovering conditional payments as compared to recovery amounts. For the past three (3) years, the liability TPOC threshold has been maintained at settlements of $1000 or less. CMS has announced via alert that the TPOC threshold for liability claims will remain …
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