Two Common Myths About Medicare Set Asides

When settling a workers’ compensation claim in any state, carriers and self-insured employers often make one of two crucial errors based on two commonly accepted compliance myths. Most focus solely on $25,000 and $250,000, the two threshold markers for determining if the Centers for Medicare and Medicaid Services (CMS) approval is required (the former if the claimant is Medicare enrolled, the latter if the claimant is expected to be enrolled
Continue reading...

The Center for Medicare & Medicaid Services Learns about Due Process: Amended Review of Approved Medicare Set-Asides and What it Means for Defense Bar

Recently, the Center for Medicare & Medicaid Services (CMS) promulgated a revised Medicare Set-Aside (MSA) Re-Review process. This “Amended Review” process is significant, as it actually provides those submitting MSAs for approval with an opportunity to revise and amend submitted MSA proposals upon an unfavorable determination from CMS. Previously, CMS has either been unwilling to re-review a submitted MSA or has limited its review following its determination. This has been
Continue reading...