Tag Archives: CMS

Confusion, Conjecture and Clarification: The New WCMSA Reference Guide

With the issuance of updated Workers’ Compensation Medicare Set-Aside Reference Guide version 2.9 (Guide), there has some speculation and even confusion as to what is really new and what is an elaboration of old policies and procedures.  Examples listed for off-label drug usage to new bullets added regarding the submission process, all of which begs […]

doctor speaking to a patient

Success in the CMS Re-Review Process

Pursuant to Section 16.0 of the Workers’ Compensation Medicare Set Aside (WCMSA) Reference Guide, Version 2.8, October 1, 2018, COBR-Q4-2018-v2.8, CMS will conduct a Re-Review of a prior WCMSA determination in certain circumstances.  Specifically, CMS will complete this process in cases involving a mistake in the allocation; mathematical error; or when there is missing documentation […]

nurse taking the blood pressure of an elderly woman

THE WHITTLING AWAY OF CMS OFF-LABEL USAGE ARGUMENTS IN THE WCMSA

With the transition to the new Workers’ Compensation Review Contractor (WCRC), the industry is seeing many changes in the Workers’ Compensation Medicare Set-Aside (WCMSA) review process. One of the biggest changes has been the shift from excluding Lyrica from the WCMSA when it is being prescribed for an off-label use to the inclusion of this […]

CMS WCRC Posts New Phone Number!

For CMS WCRC inquiries or help, call their new number—855.280.3550. Press 1: For English Press 2: For Spanish then Press 2: To enter the CMS Case Control Number (no letters) for customer service Press 3: To reach customer service directly

CMS Releases Advance Notice of Proposed Rulemaking, June 15, 2012

CMS seeks comment from industry professionals on options being considered for beneficiaries and their representatives to clarify how they can meet their obligations to protect Medicare’s interest in MSP Workers’ Comp or Liability claims. Comments must be submitted to CMS no later than 5 p.m. on August 14. Click here for more information.

NQBP Launches New Pre-MSA with Drug Regimen Review

NuQuest/Bridge Pointe (NQBP) and myMatrixx have teamed up to maximize MSA savings potential and minimize the risk of prolonged settlement negotiations! This comprehensive solution identifies and optimizes opportunities to lower costs associated with both medical treatment and pharmacy utilization. The Pre-MSA with Drug Regimen Review (PMDR) combines a medical analysis and Drug Regimen Review to […]