Blog

New Life Table to be Used

Effective January 5, 2019, the Centers for Medicare and Medicaid Services (CMS) will begin using the CDC’s “Table 1: Life Table for the total population: United States, 2015” when calculating life expectancy for Workers’ Compensation Medicare Set Aside (WCMSA) claimants. Since CMS approvals can take up to 20 business days on average, all WCMSAs submitted […]

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Lyrica Now Included in Certain Workers’ Compensation Medicare Set-Aside Arrangements

Lyrica (pregabalin) received FDA approval in 2004 and was then listed as a schedule V controlled substance, having a low potential for abuse. Approved indications for Lyrica include treatment of neuropathic pain associated with diabetic peripheral neuropathy, spinal cord injury and post-herpetic neuralgia; fibromyalgia; and as adjunctive therapy for partial onset seizures. However, it is […]

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CMS Releases Updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide

The Centers for Medicare & Medicaid Services (CMS) maintains a web portal called the Medicare Secondary Payer Recovery Portal (MSPRP) used by settling parties or other authorized persons to investigate and confirm the dollar amount of injury related medical expenses paid by Medicare. The Commercial Repayment Center (CRC) is responsible for recovery of mistaken NGHP […]

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Senate Bill 3079, Patching up the Medicare Set-Aside Process

Last month, Republican Senator Rob Portman (OH) and Democratic Senator Bill Nelson (FL) introduced a revised version of the 2014 previously failed legislation that called for the application of Medicare secondary payers rules to certain workers’ compensation settlement agreements and qualified Medicare set-aside provisions. The new and revised legislation is now known as Senate Bill […]

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Self-Administration Toolkit Updated by CMS

The Centers for Medicare & Medicaid Services (CMS) has recently issued a revised Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements (WCMSAs).  The latest version 1.2 was published on April 2, 2018.  The main purpose of this toolkit is to provide self-administering injured individuals a guideline on how to properly administer their funds.  The toolkit is vital to […]

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