Protest Delays Transition to New WCRC

Over the past year CMS has been seeking a new and qualified vendor through a Request for Proposal (RFP) process to take on the role of the Workers’ Compensation Review Contractor (WCRC). On June 16, 2011, CMS awarded Provider Resources, Inc. with the WCRC contract effective July 1, 2011. However, the transition will be delayed … Read moreProtest Delays Transition to New WCRC

CMS Awards New WCRC Contract

Over the past year CMS has been seeking a new and qualified vendor to take on the role of the WCRC through a Request for Proposal (RFP) process. On June 16, 2011, CMS awarded Provider Resources Inc. with the WCRC contract. The award notice posted by CMS on June 23, 2011 outlines the primary responsibilities … Read moreCMS Awards New WCRC Contract

Superior Court of New Jersey Allows Plaintiff Attorney’s Fees to be Deducted from MSA Allocation

There has been a great deal of commentary from the liability industry concerning the necessity of liability Medicare Set-Aside (MSA) allocations under the Medicare Secondary Payer Act (MSP), and whether the published guidance applicable for workers’ compensation MSAs  provides any insight regarding how liability MSAs should be handled. Although there is no statutory requirement to create an MSA when future medical expenses are awarded, it is recommended by the Centers for Medicare and Medicaid Services (CMS) and has become a best practice in workers’ compensation cases. In liability cases, resistance to MSAs continues due to a lack of published guidance and issues that are specific to liability cases. For example, if a settlement is only $100,000, and the projected MSA is $150,000, how can plaintiff’s attorneys get their fees if the entire settlement is taken up by an MSA?

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CMS Approval of MSA Allocations

A finalized settlement that includes a Medicare Set-Aside (MSA) where the parties have not yet obtained approval from the Centers for Medicare & Medicaid Services (CMS) can cause misunderstandings and complications, particularly on the part of claimants who are anxious to receive their settlement funds and may not understand the wait time associated with receiving CMS approval of the MSA. This was the issue that arose in Harrelson v. Arcadia, NO.2010 CA 1647, Court of Appeals of Louisiana, First Circuit. 

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