December 5, 2011— The purpose of this memorandum is to summarize and convey our support for our regulations giving Medicare Advantage organizations (MAOs) and Prescription Drug Plan (PDP) sponsors the right, under existing Federal law, to collect for services for which Medicare is not the primary payer.
September 29, 2011 — The purpose of this memorandum is to provide information regarding proposed Liability Medicare Set-Aside Arrangement (LMSA) amounts related to liability insurance (including self-insurance) settlements, judgments, awards, or other payments (“settlements”).
May 25, 2011 — This specific handout was prepared as a service to the public and is not intended to grant rights or impose obligations…It is intended to provide consolidated guidance to those attorneys, insurers, etc., working liability, no-fault and general third party liability cases for any Medicare beneficiary residing in Oklahoma, Texas, New Mexico, Louisiana and Arkansas and is not to be considered a CMS official Statement of policy.
May 11, 2011 — The purpose of this memorandum is to reiterate guidance provided in the Centers for Medicare & Medicaid Services’ (CMS’) July 23, 2001, July 11, 2005, and April 25, 2006 procedure memoranda regarding CMS’ Workers’ Compensation Medicare Set-aside Agreement (WCMSA) proposal review thresholds.
June 8, 2010 — This memorandum clarifies the guidance provided in the Centers for Medicare & Medicaid Services’ (CMS’) May 14, 2010 procedure memorandum regarding the Rated Age (RA) language to be included on WCMSA proposals.
May 14, 2010 — The purpose of this memorandum is to clarify guidance provided in the Centers for Medicare & Medicaid Services’ (CMS’) April 3, 2009 and July 1, 2009 procedure memoranda regarding prescription drugs administered to Medicare beneficiaries for off-label and/or unlabeled outpatient uses and whether these drugs are considered covered by Medicare Part D and, therefore, appropriately included in a Medicare Workers’ Compensation Set-aside Agreement (WCMSA) proposal.
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