Category Archives: Medicare Set Aside

Blog, Franco Signor News, Legal/Legislative News, Medicare Conditional Payments, Medicare Jurisdiction, Medicare Reporting Section 111, Medicare Secondary Payer News, Medicare Set Aside

The Different Paths to Protect the Medicare Trust Fund Medicare for All, Continued Privatization of Medicare and Growth of MSP Enforcement Are All on the Table Efficiency and expansion of healthcare coverage is of paramount concern in the 2020 presidential election. The Medicare program has particularly been in the spotlight, as Medicare accounts for a significant portion of federal spending. …
READ MORE

Blog, Medicare Conditional Payments, Medicare Reporting Section 111, Medicare Secondary Payer News, Medicare Set Aside

On Tuesday, January 14th, the Centers for Medicare & Medicaid Services (CMS) hosted a Town Hall to discuss common Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Ongoing Responsibility for Medical (ORM) recovery topics. On the main portion of the call, the following was discussed by John Albert and Nicole Griffin on behalf of CMS (note that CMS stated that …
READ MORE

Top Medicare Secondary Payer Predictions for 2020

03 Jan 2020 Heather Sanderson No Comments

Blog, Legal/Legislative News, Medicare Advantage Part C, Medicare Conditional Payments, Medicare Secondary Payer News, Medicare Set Aside

Medicare Secondary Payer (MSP) developments will take center-stage in 2020 and drastically impact workers’ compensation, no-fault, and general liability insurance plans/carriers. With 2020 being an election year and healthcare matters as a primary issue for Americans, the continuing debate for Medicare for All, Medicare’s rising costs with an estimate of a spend of $651 billion dollars in 2019[1], two Notices …
READ MORE

Blog, Legal/Legislative News, LMSA, Medicare Reporting Section 111, Medicare Set Aside

We have previously blogged regarding two Notice of Proposed Rulemakings (NPRMs) regarding Section 111 Civil Monetary Penalties and MSP and Future Medicals (which will propose options for LMSAs and/or protecting Medicare’s future interest in General Liability claims) pending on the Office of Management and Budget (OMB)’s website. Our prior blog on the Section 111 rulemaking can be found here and …
READ MORE

Blog, Medicare Secondary Payer News, Medicare Set Aside, WCMSA

CMS has released an updated WCMSA Reference Guide version 3.0. It can be found here.  The two significant changes are 1) CMS extending the Amended Review period from 4 to 6 years (Section 16.2), and 2) As of April 1, 2020, the required language for the signed consent form to submit an MSA to CMS now must include a statement …
READ MORE

Blog, Franco Signor News, Medicare Set Aside, WCMSA

PLOTTING A COMPLIANCE COURSE What to Consider When Determining Whether or Not to Submit an MSA to CMS By: Heather Sanderson and Claire Muselman For Workers Compensation Medicare Set-Asides (WCMSA), there is no requirement that they be submitted to the Centers for Medicare & Medicaid Services (CMS) for approval, although it is common for settling parties to do so. What …
READ MORE

Blog, Legal/Legislative News, Medicare Set Aside, WCMSA

We have blogged on numerous occasions regarding Workers’ Compensation Medicare Set-Aside (WCMSA) legislation that continues to be re-introduced in Congress with slight variations over the last decade (hereinafter referred to as “WCMSA Bill”). Our 2018 blog on the prior WCMSA Bill can be found here. The current 2019 proposed WCMSA Bill can be found here. This year, the WCMSA Bill …
READ MORE

Blog, WCMSA

Earlier this year, we blogged about CMS updating its WCMSA Reference Guide. Specifically, we pointed out that CMS for the first time included explicit examples in which the settlements would not meet CMS’ Review Threshold for review of a proposed WCMSA, but which would still require consideration of Medicare’s interests. The first example involved an under-threshold Medicare beneficiary settlement, and …
READ MORE

About Franco Signor, Administration, Blog, Legal/Legislative News

BRADENTON, Fla., April 1, 2019 /PRNewswire/ — Franco Signor announced today its new Post-Settlement Administration Services. The service platform is available to injured parties at www.CareMDRx.com. This new platform is designed for individuals that have settled their workers’ compensation or personal injury case and have future medical care needs. Post-Settlement Administration Services are commonly used by individuals who may be …
READ MORE

CMS Updates WCMSA Reference Guide and NGHP User Guide

09 Jan 2019 Heather Sanderson No Comments

Blog, Medicare Set Aside, WCMSA

Yet another indication that The Centers for Medicare & Medicaid Services (CMS) intends to make Medicare Secondary Payer (MSP) enforcement a priority in 2019: both the WCMSA Reference Guide and NGHP User Guide have been updated with several impactful changes. The updated WCMSA Reference Guide can be found here, and the updated NGHP User Guide can be found here. WCMSA …
READ MORE

© 2012-2017 Franco Signor LLC