Blog

Proceed At Your Own Risk: Failure To Properly Use ICD-10 Codes

CMS has required the use of ICD-10 Diagnosis Codes in Section 111 reporting for incidents occurring after October 1, 2015 for over four years. The use of proper diagnosis codes by responsible reporting entitles (RREs) in their Section 111 reporting serves two primary purposes – 1) it allows for the accurate coordination of benefits for […]

Read More

What is a Medicare Set-Aside Account?

When a person is involved in an accident that is due to negligence, it is an unfortunate reality that there are many financial burdens that stem from these matters. After a settlement is made in a workers’ compensation or personal injury liability case, the amount of it that is set-aside for medical care is required […]

Read More

Updated Reference Guide Now Available November 22, 2019

CMS has recently released Version 3.0 of the WCMSA Reference Guide. Changes in this version of the guide include updated addresses for reporting workers’ compensation cases; for sending yearly WCMSA account attestations; and for sending WCMSA proposals, final settlements, and re-review requests (Sections 2.2, 17.5, and 17.6). Also, changes to the Self Administration Toolkit for […]

Read More

Revised Self-Administration Toolkit for WCMSAs Now Available

Last week, CMS issued version 1.3 of the Self-Administration Toolkit for WCMSAs. The Toolkit can help claimants manage their funds appropriately and satisfy Medicare’s interests to ensure that they don’t jeopardize their entitlement to future Medicare benefits. The Toolkit outlines the entire self-administration process, from establishing the bank account for your WCMSA to exhausting or […]

Read More

New Life Tables to be Used

Effective October 7, 2019, CMS will convert to the CDC’s “Table 1: Life Table for the total population: United States, 2016“, to be utilized for Workers’ Compensation Medicare Set Aside life expectancy calculations. A link to the CDC’s 2016 Life Tables may be found here.

Read More

First Generics of Lyrica Receive FDA Approval

On July 19th, the FDA issued a press release announcing the approval of generic versions of the drug Lyrica (pregabalin). When Lyrica received initial approval by the FDA back in 2004, it was indicated for neuropathic pain associated with diabetic peripheral neuropathy. Since then, Lyrica has been indicated for a wide range of off-label uses, […]

Read More

Electronic Payments Frequently Asked Questions and Answers Document Now Available

As of April 1, 2019 authorized users who manage recovery cases in the Medicare Secondary Payer Recovery Portal (MSPRP) for Non-Group Health Plan (NGHP) cases and the Commercial Repayment Center Portal (CRCP) for Group Health Plan (GHP) cases are able to submit payments electronically via the MSPRP or CRCP. The Electronic Payments Frequently Asked Questions […]

Read More

Electronic Payment Functionality to be added to the Medicare Secondary Payer Recovery Portal

Effective April 1, 2019, The Centers for Medicare and Medicaid Services (CMS) will be adding electronic payment functionality to the Medicare Secondary Payer Recovery Portal (MSPRP). The MSPRP is utilized in non-group health (NGHP) claims which include workers’ compensation, liability and no-fault. CMS is holding a webinar for the MSRP users to discuss key items […]

Read More

New WCMSA Reference Guide Now Available

Version 2.9 of the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide has now been released and is available in the Download section of the Workers’ Compensation Medicare Set Aside Arrangements page on CMS.gov. The new version includes updates to the CDC Life Table for 2015 as well as updates for spinal cord stimulators and […]

Read More

Medicare to Consider Coverage of Acupuncture in future MSAs

One of the most common questions we receive here at MSA Meds is whether or not acupuncture is covered under a client’s MSA. In the past, the answer has been no; however, CMS has recently begun to reconsider this as a viable treatment option. On 1/15/2019, the Centers for Medicare & Medicaid Services (CMS) opened […]

Read More