Medicare Set-Aside, Workers’ Compensation, Medical Case Management
CMS has posted a redacted version of its “Operating Rules†concerning its review of Medicare set-aside proposals. There are many redactions, including for “pending litigation†and to protect “proprietary†information for its joint contractor. Protocols applauds this action by CMS (even if compelled) but questions the redactions.
A recent memo from CMS announces that a law changed Medicare’s reimbursement process for oxygen equipment and supplies. Additional information from CMS will be forthcoming, but for now, the memo says that beneficiaries must keep three things in mind:
Protocols has successfully challenged CMS concerning its July 2005 CMS Medicare Set-aside Guidance memorandum. The 10th Circuit Court of Appeals has reversed the District Court and remanded the case back for trial.
In a memorandum dated August 25, 2008, CMS released updated information regarding several topics: early termination of MSAs, clarification of acceptable rated ages, and details of funding of implantable devices.
A recent study by Avalere Health and the American Cancer Society Cancer Action Network (ACS CAN) found that Medicare Part-D beneficiaries will pay higher out-of-pocket costs for cancer medications in 2009. Restrictions on medications will also increase.
