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CMS MAKES MAJOR ANNOUNCEMENT IN LIABILITY AND NO-FAULT CASES!
Are You and Your Clients Compliant?
Thismonth CMS publishedMatter#MM9893,datedFebruary3,2017with
NoFault MSAs (“NFMSA”).
Partiesshould notetheprovisionthatthecontractorwouldreviewothernon-grouphealthplan set-asides,whichwouldbereviewsof
MSAson liability cases.TheLMSAreviewwouldbe broken downintofullreviews(similar
towhatiscurrentlydoneon workers'compensation MSAs)anda cursoryreviewwhich would only requirethat allrequireddocuments were providedforan
aseriesof indicationsfrom CMS thattheyareonce again
LMSAs.Thefirstwasin May2016whenCMSreleasedtheRFP-CMS-2016-8A-0008PRE- SOLICITATIONnotice,whichamendedtheStatementof
Non-GroupHealthPlanMedicareSetAsidesArrangements.Thiswas followedin Junewhen CMSupdateditswebsitewith
a noticetitled:"Considerationfor ExpansionofMedicareSet-
AsideArrangements."Thenoticestatesthat"the CentersforMedicareand Medicaid Services
process toincludethereviewof proposedliabilityinsurance(includingself-insurance)and no-
amounts.CMSplansto workcloselywiththestakeholdercommunityto identifyhowbesttoimplementthispotentialexpansion.CMS will
year. Pleasecontinuetomonitorthis websiteforadditionalupdates."
attorneysshould note thatCMSdoes not neednewlawtoimplementLMSAsor NFMSAs.Under42 U.S.C.Sections1395y(b)(2)and 1862(b)(2)(A)(ii)ofthe Social SecurityAct, Medicareisprecludedfrommakingpaymentwhenpayment“hasbeen madeor canreasonably be expectedtobemadeundera workers’compensationplan,an
or liability insurancepolicyorplan
insurance.”MSAs have beenusedinworkers'compensationsettlementsfornearly15 years,and
regularconsiderationinliability and nofaultsettlements.
changessincelast year and havebeen
preparingourclients accordingly. Whileothersmayadvocateusing the
workers'compensation methodology fora
is bothinappropriate and
thelegal equivalent of
a round hole.LMSAsand
administratorwithextensiveexperiencein liability and
no fault cases.CMShasannounceda targetdateofOctober1st,2017.If you wouldlike
assistance in settingup a LMSAor NFMSAcomplianceprogram,please
we wouldbe pleasedto assist you. We can be reached at (734) 433-1670 or email@example.com
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