Author: Ann S.

The Benefits Coordination & Recovery Center (BCRC) is responsible for recovering conditional payments made during the course of a workers’ compensation claim when there is a settlement, judgment, award, or other payment made to the Medicare beneficiary.  The Parties, including Beneficiaries and their attorney(s) should recognize the obligation to reimburse Medicare during any settlement negotiations, […]

As noted earlier in our series, the purpose of reporting such claims to CMS is so that CMS can assure Medicare remains the secondary payer for medical care related to the claim, and recover any applicable conditional payments.   Once the case has been reported, the BCRC will collect information from multiple sources to research […]

The Medicare Secondary Payer (MSP) provisions make Medicare a secondary payer to certain non-group health plans (NGHPs), which include workers’ compensation entities, liability insurers (including self-insured entities), and no-fault insurers.  CMS has the right to recover Medicare payments made that should have been the responsibility of an NGHP or another payer. MSP situations involving NGHPs […]

The Benefits Coordination & Recovery Center (BCRC) is responsible for ensuring that Medicare gets repaid by the beneficiary for any conditional payments. If an injured worker has Medicare and other insurance coverage, each type of coverage is called a “payer.”  When there’s more than one potential payer, there are coordination rules to decide who pays […]

CMS stands for the Centers for Medicare & Medicaid Services.  In relationship to a workers’ compensation claim, CMS is responsible for protecting the Medicare program’s fiscal integrity and ensuring that it pays only for those services that are its responsibility.  CMS captures Medicare Set-Aside (MSA) information via the Section 111 reporting process of the Medicare, […]

Recently, Medical Settlement Specialists, along with carrier MSA venders and other entities dealing with MSA submissions, have noticed a significant increase in CMS development requests, particularly in the area of CMS requesting that the submitter essentially “prove” that all claim related records for the most recent 2 years of treatment, regardless of who paid for […]

Our step-by-step process to get MSS working for you couldn’t be EASIER:Use our client portal at medicalsettlementspecialists.com to complete a case intake form and upload documents.On our intake form, tell us your settlement goals (for example, understand the medical exposure, help educate your client regarding their potential risks/benefits of settlement,  review an MSA for accuracy, identify non-Medicare covered items, […]

CMS has an updated guideline regarding request for review after an MSA has been submitted.When the following criteria are met, CMS will permit a one-time request for re-review :  Additional criteria may apply depending on case circumstances.      Do you have questions about MSAs, how to value future medical care or posturing your cases […]

For over 20 years Medical Settlement Specialists has been the Applicant Attorneys’ Go-To resource for all things future medical.   As a company dedicated to serving our clients in a personalized manner with customized products, we recognize the need to keep our services cost-effective and our delivery efficient.   We provide this level of service by focusing […]

What do we deliver? Schedule time to discuss how MSS can assist you!