The Centers for Medicare & Medicaid Services (CMS) just announced it has been reviewing its process for addressing requests for CMS to “re-review” approved Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) amounts and plans to make a change in 2017. CMS expects to update its existing re-review process to address situations where CMS has provided an approved WCMSA amount, but settlement did not occur and the medical care that supported the approved amount has changed substantially. CMS also expects its updated process to address situations where certain states rely on Utilization Review Processes to justify proposed WCMSA amounts. These two changes may be a step in the right direction for changes to the MSA review process. We will continue to provide updates when provided by CMS. In the meantime, feel free to contact us with any questions.
The information published in the Hedrick Gardner Alert is general in nature and not intended to take the place of legal advice on any particular matter. © 2016 Hedrick Gardner Kincheloe & Garofalo LLP