CMS Hits ‘Reset’ Button With Workers’ Compensation Review Contractor Procedures and Request for Approval of Zero-Dollar Medicare Set-Aside Amounts

In an announcement distributed on November 1, 2016, CMS acknowledged the receipt of many inquiries from the MSP industry regarding procedural changes in the way CMS’s  Workers’ Compensation Review Contractor (WCRC) reviews proposed zero-dollar Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) amounts.  CMS further acknowledged that as a result of these inquiries, it has determined that changes […]...Read more

CMS to ‘Consider’ Expanding Its Review Process to Include Liability MSAs

In a News Alert released Thursday, June 9, 2016, the Centers for Medicare and Medicaid Services (CMS) announced is considering expanding its voluntary Medicare Set-Aside Arrangements (MSA) amount review process to include the review of proposed liability insurance (including self-insurance) and no-fault insurance MSA amounts. CMS plans to work closely with the stakeholder community to identify […]...Read more

CMS Proposes Expansion of WCMSA Re-Review Process – The Good, The Bad & The Ugly

On February 11, 2014, the Centers for Medicare and Medicaid (CMS) announced its proposed changes to the current Medicare Set-Aside Arrangement re-review process, seeking comments and feedback by March 31, 2014. The current CMS process for WCMSA re-review requests is limited to situations where CMS is notified that the submitter omitted documentation from the original […]...Read more

CMS Releases Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide

On March, 29, CMS announced the release of a new Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide. The new guide has been posted and is available in the Downloads section of the CMS Workers’ Compensation Agency Services site at http://www.cms.gov/Medicare/Coordination-of-Benefits/WorkersCompAgencyServices/Downloads/March-29-2013-WCMSA-Reference-Guide-Version-13.pdf. The WCMSA Reference Guide was created to consolidate information currently found within the Workers’ […]...Read more

When NOT to Authorize an Additional MRI

Additional MRI States that follow the Official Disability Guidelines (ODG) do not need to authorize an additional MRI unless there are specific changes in pathology. The ODG states that ³MRI¹s are test of choice for patients with prior back surgery, but for uncomplicated low back pain, with radiculopathy, not recommended until after at least one month […]...Read more

CMS New WCMSA Decision Memo: TENS Units: Not Appropriate for Chronic Low Back Pain

The Centers for Medicare and Medicaid (CMS) issued a new memorandum that will affect pricing determinations for TENS (Transcutaneous Electrical Nerve Stimulation) units for the treatment of Chronic Low Back Pain (CLBP) included within the Workers’ Compensation Medicare Set-Aside (WCMSA) that have been submitted to CMS for approval. On June 8, 2012, CMS issued a […]...Read more