MSA
Medicare Set-Aside Basics
Medicare Set-Asides (or “MSAs”) are a construct created because the Medicare Secondary Payer Act makes it illegal for Medicare to pay for case-related treatment. Of course, this is limited to circumstances where a primary payer exists, such as a Workers’ Compensation carrier, a No-Fault carrier, or a liability defendant. But MSAs don’t exist under the law. They…
Read MoreMSAs and Reversionary Interests
Workers Compensation attorneys know the biggest trend in MSAs has little to do with the MSA itself. That trend, of course, is the reversionary interest that says unused funds will revert to the insurance carrier’s control if the claimant/plaintiff passes away. So what does Medicare think of reversionary interests? Nothing. Medicare has no…
Read MoreMASSIVE’s Ryan Weiner Speaking at the MSA Roundtable during KTLA’s Workers Compensation Section
Ryan Weiner, COO of MASSIVE, will be presenting at the Medicare Set-Asides Roundtable on Friday, December 10, 2021, from 2:30 – 3:30 p.m. (CST). Key content to be discussed at the Medicare Set-Asides Roundtable includes: The Do’s and Don’ts of MSAs and EBMSAs How to protect the Client on a MSA Proposal 30-minute Q & A Session Attendees must register and be a member of the KTLA Workers Compensation Section.
Read MoreDon’t Miss Ryan Weiner Tomorrow at the 2021 WILG SE Regional Conference!
Please join MASSIVE’s Chief Operating Officer, Ryan Weiner, tomorrow at the 2021 WILG Spring Conference. If you haven’t registered yet, do so here to join Ryan tomorrow at 8:30am CT as he takes a look at the complex process of Medicare Set-Asides and the ways to uncover hidden settlement dollars!
Read MoreMedicare Set-Aside Basics
Medicare Set-Asides (or “MSAs”) don’t exist under the law. Nevertheless, nearly all Workers’ Compensation cases, and a growing number of Liability cases, consider whether an MSA is needed. If MSAs don’t exist under the law, why do I need one? MSAs come from the Medicare Secondary Payer Act. 42 U.S.C. § 1395y(b)(2) and § 1862(b)(2)(A)(ii) of…
Read MoreLiability Medicare Set-Aside Requirements
The General “Requirements” of an LMSA: A Technical Review Medicare Set-Asides (“MSA”) cannot exist without Medicare’s right to reimbursement first being stated in the law. Those rights arise from the Medicare Secondary Payer Statute, 42 U.S.C. § 1395y(b)(2) (“MSP”) and 42 C.F.R. 411 et. seq. Then we must note that, MSP regulations and Centers for…
Read MoreMedicare to Pay for Acupuncture to Lower Opioid Use
CMS announced a coverage determination that will allow Medicare to pay for acupuncture that treats chronic low back pain. This new coverage is highly consequential in the legal industry as the stated purpose is to expand options that reduce opioid use. Opioids just so happen to be a major expense in Medicare Set-Asides (MSAs). Health…
Read MoreTrostle v. Centers for Medicare and Medicaid Services: Part II
Trostle v. Medicare: Part II Previously, we wrote about and analyzed Trostle v. Centers for Medicare and Medicaid Services. Following dismissal for lack of jurisdiction, this Medicare lien litigation continued with a counter-suit by the United States government. Part II of our case study will explore errors made that caused the government to react with…
Read MoreCMS and Liability Medicare Set-Asides
CMS’s newest time frame to create a Liability Medicare Set Aside (“LMSA”) process has come and gone. Again. We’ve seen CMS make multiple attempts to create a process and then pull them back. CMS’s Liability Medicare Set-Aside History In 2012, CMS issued an Advanced Notice of Proposed Rulemaking (“ANPR”) requesting comment on potential rules; CMS…
Read MoreNew Contractor Set to Take Over MSA Reviews
Medicare’s new Workers’ Compensation Review Contractor (“WCRC”) is set to take over all Medicare Set-Aside (“MSA”) reviews on Monday, March 19, 2018. The new contractor, Capitol Bridge, LLC, has stated it expects no changes to the process or timeframes for review. It has provided new contact information though: WCRC New Phone: 833-295-3773 WCRC New Email: [email protected]…
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