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CMS Issues Second Alert Clarifying $1,000 Reporting and Conditional Payment Recovery Amount Threshold for Liability Only

By |2014-02-21T17:41:25+00:00February 19th, 2014|Categories: Uncategorized|Tags: |

In conjunction with the alert report for February 18th, CMS provided additional clarification that the change in Threshold is  limited to physical trauma-based liability insurance settlements.  (Note: This threshold does not apply to settlements for alleged ingestion, implantation or exposure cases.) The  new threshold is effective immediately. This means that physical trauma-based liability settlements of $1000 [...]

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CMS Issues Alert Setting $1,000 Reporting and Conditional Payment Recovery Amount Threshold for Liability MSP – Questions Remain

By |2014-02-21T17:38:33+00:00February 18th, 2014|Categories: Uncategorized|Tags: |

On February 18, 2014, CMS issued an alert indicating that it could set a threshold under which liability settlements would no longer need to be reported to CMS under MMSEA Section 111 and also would not require conditional payment reimbursement under the MSP. A copy of the alert can be found here. Unfortunately, the Alert raises [...]

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CMS Seeks Comments on Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Re-review Proposal

By |2014-02-18T19:26:24+00:00February 12th, 2014|Categories: Uncategorized|Tags: |

The Centers for Medicare and Medicaid Services (CMS) announced on February 11th that it is seeking comments on the manner in which CMS plans to expand the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) re-review process. See : http://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Workers-Compensation-Medicare-Set-Aside-Arrangements/Downloads/WCMSA-Re-review-Expansion.pdf.  Currently, CMS has a limited re-review process for WCMSA amounts that can be used in situations where CMS [...]

UWC Submits Comments on Section 111 Civil Money Penalties Rules

By |2014-02-21T18:01:18+00:00February 10th, 2014|Categories: Uncategorized|Tags: |

In response to the Advance Notice of Proposed Rulemaking (ANPRM) at http://www.gpo.gov/fdsys/pkg/FR-2013-12-11/html/2013-29473.htm, UWC submitted comments to the Centers for Medicare and Medicaid Services (CMS). Attached are the complete comments. The primary points of the comments are summarized below. Comments Congress clearly indicated that civil money penalties were not to be imposed in all cases as a [...]

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Agreement on SGR 5 Year Fix: Possible Vehicle for WC & MSP Amendments

By |2014-02-07T21:01:23+00:00February 7th, 2014|Categories: Uncategorized|

House Ways and Means Committee Chairman Dave Camp (R-Mich.), Senate Finance Committee Chairman Max Baucus (D-Mont.), Senate Finance Committee Ranking Member Orrin Hatch (R-Utah), House Ways and Means Committee Ranking Member Sander Levin (D-Mich.), House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and House Energy and Commerce Committee Ranking Member Henry A. Waxman (D-Calif.) today [...]

CMS Publishes Proposed Rules for Appeal of MSP Conditional Payment Determinations

By |2014-01-21T21:45:28+00:00December 27th, 2013|Categories: Uncategorized|

The Centers for Medicare and Medicaid Services (CMS) on December 27, 2013 published proposed rules with respect to the Right of Appeal for Medicare Secondary Payer Determination Relating to Liability Insurance (including Self-Insurance), No Fault Insurance, and Workers’ Compensation Laws and Plans. The proposed rules may be found at http://www.gpo.gov/fdsys/pkg/FR-2013-12-27/pdf/2013-30661.pdf# and provide for comments to be [...]

CMS Releases Updates to WC MSA Reference Guide

By |2014-01-28T16:54:46+00:00November 6th, 2013|Categories: Uncategorized|

In release dated November 6, 2013, the Centers for Medicare and Medicaid Services is providing an updated version of the Reference Guide. The following sections of the Guide have been enhanced or added: 9.4.1.1 – Most Frequent Reasons for Development Requests: The five most common omissions as provided by the WCRC. 9.4.2  – WCRC Team Background [...]

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