This past week the Office of Management and Budget posted two rulemaking notices from the Centers for Medicare and Medicaid Services (CMS), one with implications for the consideration of future medicals in liability settlements and the other regarding criteria for…

Lyrica is a brand name only medication which costs $8.91 per pill at 150mg. Over a 20-year life expectancy, this is close to $200K in an MSA allocation. Until recently, CMS largely excluded Lyrica from the MSA on the basis…

On 10/1/2018, the Centers for Medicare and Medicaid Services (CMS) released updates to the Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide, the Medicare Secondary Payer Recovery Portal (MSPRP) User Guide and the MMSEA Section 111 Medicare Secondary Payer Mandatory Reporting…

CMS has signaled its intent to expand its voluntary WCMSA review program to liability. While a liability review policy has yet to be announced, CMS has made clear it expects the burden of post-settlement medicals should not be shifted to…

Tower MSA Partners brings you WCI-TV, the televised coverage of the WCI Conference (Aug. 19-22). Be sure to tune into WCI-TV in the conference hall or your hotel or while shuttling back and forth for insights on the topic of…

CMS recently announced it is hosting a webinar on Thursday, August 16, 2018, at 1:00 PM ET to “present the benefits of using the MSPRP.”  The webinar will also include an update on the new MSPRP features which Tower MSA…

Since its introduction six years ago, the Medicare Secondary Payer Recovery Portal (MSPRP) has increasingly become more reliable and useful in communicating to and receiving information from the Medicare conditional payment recovery contractors (BCRC and CRC).  Earlier this month, a…

In today’s digital environment, if you are an employer, carrier or TPA, you are likely inundated with data.  You get claims data, medical and pharmacy data, predictive analytics, benchmark performance data, claim reports, drug interaction, duplicate therapy and contraindication notices,…

Since April 2018 the Centers for Medicare and Medicaid Services (CMS) has been issuing new Medicare identification numbers to some 60 million active Medicare beneficiaries. Pursuant to the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, a Medicare Beneficiary…

A Philadelphia personal injury firm and its principal recently entered into a settlement agreement with the U.S. Attorney for the Eastern District of Pennsylvania to pay a lump sum of $28,000 for repayment of Medicare conditional payments. The June 18,…