Category Archives: Medicare Set Aside

An Excellent Method to Properly Reduce the LMSA

22 Apr 2013 Roy Franco No Comments

Blog, LMSA

Whether you have participated in the Centers for Medicare & Medicaid Services (“CMS”) Town Hall Conferences, or read the recent court decisions on confirming the Liability Medicare Set Aside (“LMSA”) it is abundantly clear that CMS does not currently require, approve or have a stated policy regarding the LMSA – yet CMS states unequivocally its interests must be protected.  How …
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New WCMSA Reference Guide Summary

15 Apr 2013 admin No Comments

Blog, WCMSA

The attached Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide has been posted to the CMS.gov webpage.  This reference guide was created to help explain the WCMSA approval process and to serve as a reference guide for those electing to submit their WCMSAs to CMS for approval. The reference guide consolidates information currently found within the Workers’ Compensation Agency Services …
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Close Call for Employer on Unapproved MSA

09 Apr 2013 Jeff Signor No Comments

Blog, Medicare Secondary Payer News, Medicare Set Aside

Rainey v. The GoodYear Tire & Rubber Company, 2013 N.C. Facts:  Rainey, a tire builder injured his back on August 4, 2004.  During the course of his claim, a Medicare Set Aside was prepared in the amount of $65,948.  The Parties agreed to settle the workers’ compensation claim for $315K plus the MSA.  Subsequent to the acceptance of the deal, …
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Blog, WCMSA

On October 2, 2012, the Centers for Medicare & Medicaid Services (CMS) issued a memorandum to Part D Sponsors concerning the transition to Part D Coverage of Benzodiazepines and Barbiturates beginning in 2013. Effective June 1, 2013, all  Workers’ Compensation Medicare Set-Aside (WCMSA) proposals submitted to CMS for a review of the adequacy of the proposal amount are to include …
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New WCMSA Reference Guide Posted

01 Apr 2013 Jesse Hamby No Comments

Blog, Medicare Set Aside, WCMSA

A new Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide has been posted and is available for download below. This reference guide was created to consolidate  information currently found within the Workers’ Compensation Agency Services webpages and CMS Regional Office Program Memorandums, while providing WCMSA information to attorneys, Medicare beneficiaries, claimants, insurance carriers, representative payees, and WCMSA vendors.   Please continue …
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LMSA

A few weeks ago, the Superior Court for the State of Connecticut in the Judicial District of Litchfield was presented with a Motion by the Plaintiff to “Determine that the Parties Have Reasonably considered Medicare’s Interests As Required by the Medicare Secondary Payor (sic) Act, 22 U.S.C. §1395v”.  All parties joined the Motion and the Court granted it.  The Centers …
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LMSA Required or Not – Florida Court Weighs In

08 Feb 2013 Roy Franco No Comments

Blog, Medicare Set Aside

The question everyone wants answered is whether a LMSA is required as part of the settlement of a liability claim.  The short answer is no.  The Centers for Medicare & Medicaid Services (CMS) is responsible for the administration of the Medicare program but it has yet to issue regulations on the topic.  Last June, CMS started the process toward possible …
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WCMSA

The WCMSAP or Workers’ Compensation Medicare Set-Aside Portal has been improved to allow for two type of reconsiderations. These reconsiderations have been broken down by CMS into the follow two options: Option 1 If you believe CMS’s determination contains obvious mistakes (e.g., a mathematical error or failure to recognize Medical records already submitted showing a surgery, priced by CMS, that …
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Allocation, Medicare Conditional Payments, Uncategorized, WCMSA

On December 17, 2012 CMS announced they will be updating the life tables that allocators use when calculating life expectancy in WCMSAs. The impact will be an overall increase in life expectancy, although minimally, which will result in slightly higher costs in some situations. It is important to know that if a file has a pending WCMSA timely submission is …
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Franco Signor CEO Featured in New Article

14 Dec 2012 Jesse Hamby No Comments

Franco Signor News, Medicare Set Aside

Franco Signor CEO John Williams has just been featured in the Gulf Coast Business Review.  Mr. Williams pioneering ventures in the world of Medicare Set-Asides have come full circle.  His current role at Franco Signor is not only a worthwhile cure for his “post-retirement” boredom, it is also an incredibly good fit for the team that founded the company in …
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