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Tag: CMS

What Can a Practitioner Expect from the CMS Review Process?

Jan 4, 2023
The first step in getting a Medicare set aside (MSA) approved by the Centers for Medicare and Medicaid Services (CMS) is to consult with a qualified MSA professional, such as...

The Top 5 Reasons CMS Will Issue a Development Request

Jan 4, 2022
Nothing is more frustrating than reaching a workers’ compensation settlement only to have it delayed by weeks or months due to problems with the Medicare Set Aside (MSA) submission. One...

What Criteria Does CMS Use When Reviewing an MSA?

Jan 4, 2022
According to the WCMSA Reference Guide, the Workers’ Compensation Review Contractor will consider the following factors in making a decision about the adequacy your Medicare Set Aside: • The past...

CMS Issues Annual Mandatory Insurer Reporting Threshold

Dec 17, 2021
The Centers for Medicare & Medicaid Services (CMS) have again set the mandatory reporting threshold for physical trauma-based insurance settlements at $750. According to this alert, CMS will maintain the...

Will CMS Re-Review an Approved MSA?

Jan 21, 2020
Here is the latest content from our YouTube channel addressing the issue of re-review and amended review of an approved MSA. https://binged.it/2RcV4tu

CMS Announces New Guidelines For Re-Review Of Previously Approved WCMSAs

Jul 26, 2017
In the WCMSA User Guide version 5.1 which was published on July 10, 2017, CMS finally expanded the circumstances under which they will consider a re-review of a previously approved...

The Use of Future Medical Cost Projections

Jun 22, 2017
Have you struggled with what it means to “consider Medicare’s interests” where your case does not fall within the CMS review thresholds.  While CMS has not specifically defined how it...

CMS Signals Use of LMSAs In 2017

Jun 17, 2017
Over the past few weeks, the Centers for Medicare and Medicaid Services (CMS) has strongly signaled that it will begin taking steps to enforce the Medicare Secondary Payer (MSP) Act...