After needling from the medical community, in a sharply written January 21, 2020 decision memo, the Centers for Medicare and Medicaid Services (CMS) got right to the point in announcing Medicare will now cover acupuncture for chronic low back pain. …

Understanding and Preventing Cybersecurity Threats February 19, 2 PM ET Minnesota Hospital Breach Impacts Personal and Medical Data of 50,000 Patients A Billion Medical Images Exposed, but Doctors Ignore Warnings Names, Social Security Numbers Exposed in Moss Adams Breach These…

On January 14, 2020 CMS held a Town Hall to discuss common Commercial Repayment Center (CRC) NGHP ORM Recovery topics.  In attendance on the call were various officials from CMS as well as Performant Recovery the CRC contractor.  For the…

Obtaining CMS recognition of state statutory limitations on medical care in order to limit the MSA allocation has always proven difficult, but not impossible.  As those who have Georgia WC claims know, since July 1, 2013, the state limits medical…

As we come to the end of 2019, put on your party hats, toot your horns and clink your champagne glasses, as we introduce Tower’s MSP Compliance Countdown.  The MSP Compliance Countdown provides a quick summary of, in our opinion,…

The Centers for Medicare and Medicaid Services (CMS) recently announced a town hall “to discuss common Commercial Repayment Center (CRC) NGHP ORM Recovery topics.”  The town hall will be held on Tuesday, January 14, 2020 (There is a typo in…

In a 11/26/2019 Alert, the Centers for Medicare and Medicaid Services (CMS) announced that the 2020 recovery threshold for liability, no-fault and workers’ compensation settlements will remain at $750. Accordingly, Total Payment Obligations to the Claimant, TPOCs, in the amount of…

Almost a year ago the U.S. Office of Management and Budget posted two rulemaking notices from the Centers for Medicare and Medicaid Services (CMS) entitled Civil Money Penalties and Medicare Secondary Payer Reporting Requirements and Miscellaneous Medicare Secondary Payer Clarifications…

CMS recently released Version 3.0 of its WCMSA Reference Guide, what we informally call the “MSA bible.”  The reference guide provides most CMS policy and procedures relating to its review of Workers’ Compensation Medicare Set-Asides. The updated guide can be…

Some employers, carriers and other payers think Medicare Set-Asides (MSAs) are all pretty much the same, a commodity.  A company calculates future medical expenses and sends a report with an allocation to the Centers for Medicare and Medicaid Services (CMS),…