A Holiday Present from CMS

Foreshadowing a major change to Medicare Set-Asides (MSAs), the Centers for Medicare & Medicaid Services (CMS) announced on Wednesday, December 21, that it would unveil new policies in 2017 regarding re-review of MSAs and the use of utilization review in MSAs. The CMS announcement suggests that parties may soon be afforded a second bite of […]

Medication Trends to Watch

It’s no surprise that prescription medications are often the biggest cost driver in a Medicare Set-Aside (MSA). Physicians routinely prescribe costly medications to treat claimants’ injuries and manage their symptoms with the goal of returning them to normal activities as quickly as possible. Insurers can implement multiple strategies to reduce the overall cost of a […]

Impact of Utilization Review on Medicare Set-Asides

Although Utilization Reviews (URs) and Independent Medical Reviews (IMRs) have been used in state jurisdictions for years, insurers have only recently focused on how the Centers for Medicare and Medicaid Services (CMS) treats URs and IMRs when evaluating Medicare Set-Asides (MSAs). Since URs and IMRs can offer significant cost savings, claims examiners are becoming keenly […]