Cases & Points Blog

CMS Issues 2020 MSP Recovery Thresholds

On November 27, 2019, CMS issued the 2020 Recovery Thresholds for Certain Liability Insurance, No-Fault Insurance, and Workers’ Compensation Settlements, Judgements, Awards, or Other Payments. Starting January 1, 2020 physical-based liability insurance settlements will remain $750.  For no-fault and workers’ compensation settlements that do not include ongoing responsibility for medical, the threshold will also remain […]

CMS Issues NGHP Alert Regarding Medicare Beneficiary Identifier Reporting

Pursuant to the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, CMS replaced beneficiary Medicare cards containing Social Security based Health Insurance Claim Numbers (HICN) with a new unique Medicare Beneficiary Identifier (MBI).  Although MBIs will officially be utilized by CMS January 1, 2020,  MACRA does provide an exemption for the use SSN based […]

CMS Issues New WCMSA Reference Guide 3.0

From new language added to Consent to Release forms to a focus on professional administration, CMS’ new User Guide contains some important substantive and procedural changes. Recommended Professional Administration of WCMSA Accounts: Section 17.1 has been updated to include Medicare’s recommendation to professionally administer MSA’s that include “Frequently Abused Drugs” as defined by CMS’ Part […]

CMS Issues New Self-Administration Tool Kit

CMS has issued a new Self-Administration Tool Kit for Workers’ Compensation Medicare Set-Aside Arrangements (WCMSA) version 1.3.  Changes from the prior version of the Tool Kit  include new information on the enhancement of the WCMSA Portal allowing the beneficiary,  his/her representative, or other identified administrator to electronically file yearly attestation statements.  In addition, Section 10 […]

Medicare Compliance Spooktacular

In this Halloween edition of our NuQuest blog we highlight some of the tricks and treats that have been passed down to us by CMS in 2019.  Tricks LMSAs/No-Fault MSAs Proposed Rulemaking for LMSA/No-Fault cases was originally set to be released in September 2019.  This was then pushed back to October 2019.  Although the month/year […]

Section 111 Penalties Closer Than We Think?

According to information located on the Office of Information and Regulatory Affairs (OIRA) website, the proposed rule for Civil Money Penalties and Medicare Payer Reporting Requirements is currently under review as an executive order submission.  This was received on September 19, 2019.  As noted in our prior blog, the proposed rule was pushed back to […]

Workers’ Compensation Medicare Set-Aside Electronic Attestation Enhancement

CMS will be hosting two webinars on the new Workers’ Compensation Medicare Set-Aside (WCMSA) Electronic Attestation Enhancements.  The first webinar will take place on October 30. 2019 and is directed to Medicare beneficiaries and their representatives.  The second webinar will be directed to Professional Administrators and will be held on November 6, 2019.  Additional details […]

More Scrutiny Being Placed on Administration Of MSA Funds

A class action suit that was recently filed in the Northern District Court of Alabama and was thereafter withdrawn voluntarily highlights post-settlement scrutiny of the administration of MSA funds.  In the Complaint filed on behalf of Joshua Sharp and similarly situated individuals, it was alleged that a post-settlement administration company, Ametros Financial Corp., advertised various […]

New Life Tables for WCMSAs

Beginning October 12, 2019, CMS will be utilizing the CDC’s “Table 1: Life Table for the total population: United States, 2016“ for the Workers’ Compensation Medicare Set Aside life expectancy calculations. A link to the CDC’s 2016 Life Tables may be found here  CDCs 2016 Life Tables

Brace for Changes to the MSA and Section 111 Process

The Medicare compliance industry continues to brace for changes to the MSA and Section 111 process based upon Notice of Proposed Rulemaking issued by CMS in 2018.  Many questions continue to loom regarding this process and particularly how the claimant and defendants will be protected if these rules are implemented. With various industry studies and […]