Medicare Set-Asides are No Longer Set in Stone

The Centers for Medicare & Medicaid Services (CMS) has long followed a clear path toward revising MSAs: You couldn’t. CMS has finally changed its tune. Its newest Workers Compensation Medicare Set-Aside User Guide lays out those changes. First – let’s review the soon-to-be-forgotten, defunct MSA re-review process. The old process did not allow re-review where…

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Update on Liability MSAs: When, Not If

CMS is finally, officially, directly acknowledging that Liability Medicare Set-Aside Arrangements (LMSAs) are coming. Guidance is due. Medicare’s Change Request 9893  and its MLN Matters bulletin on the subject was revised on June 8, 2017. That revision includes the clearest statement that Medicare liens are just part of the puzzle. The newest piece to that…

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Medicare Numbers Revamped

CMS announced that it will begin moving away from its current ID system. That system has long relied on Social Security Numbers as the basis for Medicare’s “Health Insurance Claim Number” or HICN (its name for what we refer to as the Medicare number). While this change is a major positive step toward reducing identity theft,…

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CIGA v. Price – Medicare’s Multiple Diagnosis Code Problem

In January, a California District Court attacked Medicare’s system of lumping related and unrelated diagnosis codes into payments. The problem lays in Medicare’s inflexible recovery system that essentially claims, if one code is related to the sued-for injuries, the entire payment must be repaid to Medicare. We blogged about it in January and noted that…

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Medicare is preparing for LMSAs. Are you ready?

Liability Medicare Set Aside. If you don’t know what an “LMSA” is yet, you’ll need to learn fast. On February 3, 2017, the Centers for Medicare and Medicaid Services (CMS) published Change Request 9893. It establishes new processes for LMSAs and No-Fault MSAs (“NFMSAs”) effective October 2, 2017. CR 9893 is directed to Medicare Administrative…

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