Prescription drug updates may positively affect Medicare Set Aside

As part of our best business practices, we continually monitor RED BOOK®Average Wholesale Price (AWP) of the most common medications present in Workers’ Compensation Medicare Set-Aside (WCMSA) arrangements. This practice assists in identifying price changes positively affecting WCMSAs. The month of February brought price drops of the following medications: buprenorphine/naloxone (Suboxone®) commonly prescribed for opioid … Read morePrescription drug updates may positively affect Medicare Set Aside

Summary of Final Rule: Conditional Payment Appeals Process for Applicable Plans

On February 27, 2015, CMS published in the Federal Register the SMART Act Appeal Final Rule which can be located at 80 Fed. Reg. 10611. The rule can be found here and will go into effect on April 28, 2015. CMS had previously issued the Proposed Rule on this very topic on December 27, 2013. Materially, the … Read moreSummary of Final Rule: Conditional Payment Appeals Process for Applicable Plans

CMS Publishes Self Administration Toolkit for WC Medicare Set Asides

On March 21, 2014, CMS published its first Self Administration Toolkit for Workers Compensation Medicare Set Aside Arrangements (WCMSA). CMS had previously provided significant leadership on WCMSA administration matters through the several Policy Memos and Reference Guide it had published over the preceding 14 years. However, this was their first attempt at focusing on self … Read moreCMS Publishes Self Administration Toolkit for WC Medicare Set Asides

CMS Publishes WCMSA Reference Guide Version 2.3

On March 29, 2013, the Centers for Medicare & Medicaid Services (CMS) published its first Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide to “help stakeholders understand the process used by CMS for approving proposed WCMSA amounts and to serve as a reference for those choosing to submit such amounts to CMS for approval, including … Read moreCMS Publishes WCMSA Reference Guide Version 2.3