Ethics in Lien Resolution Webinar

webinar

Please join MASSIVE for our webinar “Ethics in Lien Resolution: The Practical Guide to your Decisions” on Tuesday, September 15th at 1pm EDT.  We will be discussing how to navigate legal and ethical requirements that law firms face today when handling lien resolution for their clients. Our free webinar will provide you with tools to…

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Lien Resolution & MSP Compliance CLE *register today*

Join us tomorrow as we partner with Ametros & WILG to learn* about solutions in claims resolution, MSP compliance, and professional administration. *CLE Credit available in selected states. Topics will include: • New Requirements in Medicare Consent to Release Forms: Beginning on April 1, 2020, the Centers for Medicare & Medicaid Services (CMS) will require…

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Liability Medicare Set-Aside Requirements

do you need an msa

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…

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Medicare Set-Asides in California

NEWS

California Applicant Attorneys Can Petition for Reimbursement for Costs Associated with Medicare Set-Asides (MSA). Specific language regarding reimbursement of an Medicare Set-Asides is found under Petition of Costs in Section 10545 (formerly section 10451.3): (a) Petition for costs is a petition seeking reimbursement of an expense or payment for service not allowable as a lien…

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Medicare to Pay for Acupuncture to Lower Opioid Use

medicare to pay for acupuncture

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…

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CMS 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…

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New 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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CRC Transition Begins Today (February 7, 2018)

Please remember Medicare liens for what it considers No-Fault and Workers’ Compensation files may not change for a few days. Performant Recovery, Inc. officially takes over tomorrow, February 8, 2018; however, CGI is handing off all data beginning today, February 7, 2018. All CRC files will re-start processing (mail, faxes, etc.) on Monday, February 12, 2018.…

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CMS’s New Medicare Set-Aside Contractor

CMS can finally move forward with its new Medicare Set-Aside (“MSA”) contractor. While that contract was awarded in September, two organizations challenged that award arguing that CMS “unreasonably failed to permit offerors to make oral presentations and failed to conduct discussions.” More interesting, Arch Systems, LLC argued that the agency “failed to reasonably evaluate the…

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Connections between Medicare & Medicare Advantage Plans

Medicare (CMS, BCRC, CRC, or any other contractor) does not speak for Medicare Advantage Plans (“MA Plans”). MA Plans do not speak for Medicare. These two statements could not be more important as MA Plan providers like Humana become more aggressive in suing to enforce their Medicare Part C liens. Last week, an attorney asked…

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