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CMS Announces New $750 Threshold For Conditional Payments In WC Claims

CMS just implemented a $750 threshold for workers’ compensation settlements, where the insurer does not otherwise have ongoing responsibly (ORM) for medicals.

This means that insurers are not required to report, and CMS will not seek recovery for conditional payments, on settlements that are less than $750. This new rule is rather limited in scope as it would only seem to apply to nuisance value settlements on denied claims.

CMS Issues Notice of Proposed Rulemaking for Conditional Payment Appeals

Do You Need An MSA In Liability Cases?

The time has long since passed where a responsible personal injury lawyer can afford to ignore Medicare’s interests for future medical expenses in liability cases. The preferred method of considering Medicare’s interests for future injury-related medical expenses in liability cases is yet to be clearly outlined by statute or regulation. Although the current law certainly does not mandate the use... of Medicare set-asides in liability cases, it has become increasingly apparent over the last few years that CMS does intend to enforce the requirement that Medicare’s interests be protected, not only for pre-settlement conditional payments, but for future injury-related expenses as well.

CMS Signals Intention to Issue Rules for Medicare Compliance in Liability Cases

CMS recently publishedRIN: 0938-AR43in follow-up to its Advanced Notice of Proposed Rulemaking which solicited public comment on a proposed rule regarding standardized options that they were considering making available to beneficiaries and their representatives in order to clarify how parties settling a liability claim could meet their obligations to consider Medicare’sinterest. CMS provided seven options for satisfying Medicare’s interest when settling future medical benefits as a result of an injury or accident.

Notice of Proposed Rule Making in Liability Cases Coming Soon

Notice of Proposed Rule Making in Liability Cases Coming Soon
The U.S. Department of Health & Human Services (HHS) has indicated that it will issue a Notice of Proposed Rule Making to give some clarity on the preferred method of addressing future medical costs in liability cases. The HHS has issued an agenda item indicating that September 2013 is the earliest that CMS could proceed with issuing parameters for funding Medicare beneficiaries’ future medical expenses in liability claims.

Workers' Compensation Impact on Collateral Benefits

Gregory Lisowski of MSA Services, LLC will be moderating a seminar at the 100th Anniversary of the Workers' Compensation Act Symposium entitled:Workers' Compensation Impact on Collateral Benefits (Medicare, Medicaid, Social Security, Unemployment)
October 3, 2013
Crowne Plaza, Cromwell, CT
Angelo Sevarino, Esq., Morrissey, Morrissey & Mahoney, Naugatuck, CT
Henry Zaccardi, Esq., Attorney, Shipman & Goodwin, Hartford, CT

MSA Services, LLC Welcomes PMA Management Corp. of New England

MSA Services, LLC is pleased to welcome PMA Management Corp. of New England as a new client.

WCMSA Reference Guide

CMS has posted a new WCMSA Reference guide on their website.  Click on the link below to open.

MSA Services, LLC Announces Two New Clients

MSA Services, LLC just added Yale New Haven Hospital and the Town of Greenwich to their client list.

President Obama Signs the Strengthening Medicare and Repaying Taxpayers (SMART) Act Into Law

On January 9, 2012, the President signed the Strengthening Medicare and Repaying Taxpayers (SMART) Act into law. The SMART Act represents one of the most significant changes to the conditional payment recovery process since the MSP Statue was enacted.
The SMART Act amends the Medicare Secondary Payer Statue by adding the following language at the end of the existing statute:
  • Section 201 - Expedited Repayment, Web Portal and Right of Appeal.This section requires CMS to maintain and make available a timely updated website so settling parties can determine how much is owed to CMS for conditional payments, during the settlement process.