Bylined Articles

Quoted in Industry Publications

PMSI Perspectives

PMSI Government Affairs Alerts

PMSI Settlement Solutions Government Affairs Alerts

September 9, 2009 — CMS Alerts Issued: Obtaining Social Security Numbers for Non-Group Health Plan Reporting and Documentation Concerning MMSEA Section 111 COB Secure Web Site Registrations
August 19, 2009 — CMS Issues Version 2.0 of Medicare/Medicaid and SCHIP Extension Act (MMSEA) Section 111 and CMS Issues Documentation Regarding Authorized Representative and Account Manager Designation
July 30, 2009 — CMS Issues Alert Regarding Periodic Workers' Compensation Payments
June 4, 2009 — CMS Issues Prescription Drug Set-Aside Guidance for Submitters
April 16, 2009 — CMS Releases Alert for Reporting Multiple TPOC Amounts
March 24, 2009 — Mandatory Insurer Reporting Requirement - User Guide Update - CMS Releases Two New Documents
August 8, 2008 — Medicare Secondary Payer Mandatory Insurer Reporting Requirements
June 6, 2008 — CMS Policy Memorandum
January 21, 2008 — The Medicare, Medicaid, SCHIP Extension Act of 2007

PMSI Drug Advisories

PMSInfo—Clinical Newsletter

Pain Management Resource Center

Legal Bulletins

CMS Memos

The memos listed below are taken directly from the Centers for Medicare & Medicaid Services (CMS) website, and are solely owned and released by their agencies.

June 01, 2009 — Since the publication of the April 3, 2009 CMS policy memorandum announcing prescription drug reviews, which becomes effective June 1, 2009, submitters of Workers’ Compensation Medicare Set-aside Arrangements (“WCMSAs”) have raised several questions...

April 03, 2009 — The purpose of this memorandum is to set forth the Centers for Medicare & Medicaid Services’ (CMS’) procedures regarding the methodology of pricing future prescription drug treatment costs/expenses in Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) proposals.

August 25, 2008 — The purpose of this memorandum is to include policy regarding the pricing of Implantable Devices and to replace the policies regarding “Beneficiaries that Request Termination of a Workers’ Compensation Medicare Set-Aside (WCMSA) Account” in Question and Answer 10 of the July 11, 2005 Associate Regional Administrator memorandum.

May 20, 2008 — The purpose of this memorandum is to include policy regarding the exclusive use of the Centers for Disease Control (CDC) Table 1 (All American Table) when determining life expectancy in Workers’ Compensation Medicare Set-Asides (WCMSA) proposals. The Centers for Medicare & Medicaid Services (CMS) will only accept life expectancies obtained from the CDC Table 1, “Life table for the total population.”

July 24, 2006 — This memorandum supersedes the Part D and Workers’ Compensation Medicare Set-aside Arrangements (WCMSA) memorandum that was published on December 30, 2005. It includes policy regarding the inclusion of future prescription drug treatment costs/expenses in WCMSAs.

April 25, 2006 — The purpose of this memorandum is to replace Q/A #2 of the July 11, 2005 Memorandum with regard to the Centers for Medicare & Medicaid Services’ (CMS’) low dollar WCMSA threshold for Medicare beneficiaries. Effective with the issuance of this memorandum, CMS will only review new WCMSA proposals for Medicare beneficiaries where the total settlement amount is greater than $25,000.00.

December 30, 2005 — Beginning January 1, 2006, Medicare will begin its Part D prescription drug coverage as a result of the implementation of the Medicare Modernization Act of 2003 (MMA). This memorandum includes policy regarding the inclusion of prescription drugs that Medicare will cover as of January 1, 2006, in Workers’ Compensation Medicare Set-aside Arrangements (WCMSAs).

July 11, 2005 — Medicare Secondary Payer (MSP) – Workers’ Compensation (WC) Additional Frequently Asked Questions

October 15, 2004 — Medicare Secondary Payer (MSP) — Workers’ Compensation (WC) Additional Frequently Asked Questions: 1) Use of WC Fee Schedule vs. Full Actual Charges for WC Medicare Set-aside Arrangement (WCMSA); 2) Self-administration of a WCMSA; 3) Up-front Settlement of Future Medicals vs. WCMSA; 4) Inflation Adjustment/Discount to Present Value; 5) Structured WCMSAs; 6) WC Claim Resolution Where Medicals Remain Open.

May 07, 2004 — The purpose of this all regional administrators memorandum is to replace the policy that was outlined in the answers to the questions in the all associate regional administrators (ARA) memorandum concerning workers’ compensation commutation of future benefits.

May 23, 2003 — Medicare Secondary Payer -- Workers’ Compensation (WC) Additional Frequently Asked Questions

April 22, 2003 —Medicare Secondary Payer -- Workers’ Compensation (WC) Frequently Asked Questions

July 23, 2001 —Workers’ Compensation: Commutation of Future Benefits

Industry Quick Links

Medicare
http://www.medicare.gov/

Centers for Medicare and Medicaid Services (CMS)
http://www.cms.hhs.gov/

CMS Workers’ Compensation Services
http://www.cms.hhs.gov/WorkersCompAgencyServices/

CMS Mandatory Reporting
https://www.cms.hhs.gov/MandatoryInsRep/

CMS Workers’ Compensation Agency Services Contact List- Regional Offices
http://www.cms.hhs.gov/WorkersCompAgencyServices/Downloads/cmscontactlist.pdf

CMS / Sample Case Submission
http://www.cms.hhs.gov/WorkersCompAgencyServices/Downloads/samplesubmission.pdf

CMS / Open Door Forums
http://www.cms.hhs.gov/OpenDoorForums/01_Overview.asp#TopOfPage

Social Security
http://www.socialsecurity.gov/

Medicare Secondary Payer Recovery Contractor (MSPRC)
http://www.msprc.info/index.cfm?content=main

United States Life Table
http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_09.pdf