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The Centers for Disease Control Publishes 2006 U.S. Life Tables |
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Industry News Updates
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Thursday, 15 July 2010 14:37 |
Written By: Tom Matson
On July 9, 2010, The Centers for Disease Control (CDC) published the 2006 United States Life Tables. This new table comes on the heels of the 2005 life table that just went into effect about three months ago. Effective July 19, 2010, the CMS will begin referencing CDC's Table 1: Life table for the total population: United States, 2006 for all Workers’ Compensation Medicare Set Asides (WCMSAs). As a result, CMS will apply the new life table on any newly submitted or reopened WCMSA received on or after July 19, 2010.
To view the CDC’s Table 1: Life table for the total population: United States, 2006, please click here.
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Dr. Ronald Berwick is New CMS Head |
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Industry News Updates
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Friday, 09 July 2010 12:41 |
By Doug Shaw, C.P.A.
President Obama, by way of a recess appointment, appointed Dr. Donald Berwick, age 63, this week as the administrator of the Centers of Medicare and Medicaid Services (CMS), a post that has been vacant since 2006. Dr. Berwick is a pediatrician and a professor at the Harvard Medical School. He is also the president and CEO of the Institute of Healthcare Improvement (IHI), a not-for-profit organization based in Cambridge, Massachusetts, working to improve healthcare in the US and throughout the world.
His supporters, which include the American Medical Association, the American Hospital Association, the AARP, AFL-CIO and many health organizations, say that he is an expert, dedicated to improving health care quality and safety while at the same cutting cost. His critics say Dr. Berwick is a proponent of rationing healthcare and loves the socialized British National Health System.
Liberals and conservatives are butting heads (so, what else is new) that this Obama appointment was done while the Senate was in recess thereby by-passing the senate confirmation process until the end 2011. Liberals are saying that this important appointment just can’t wait. Conservatives are saying Obama shouldn’t have bypassed the senate confirmation process.
For the official White House announcement click here. |
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CMS Revises Recent Statement on Rated Ages |
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Industry News Updates
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Tuesday, 22 June 2010 14:29 |
Written By: Tom Matson
The Centers for Medicare and Medicaid Services (CMS) recently issued a revised statement to be included as part of a Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) proposal. Effective immediately, the Rated Age certification originated by the May 14, 2010 memo is revised to state the following:
“Our organization certifies that all rated ages we have obtained and/or have knowledge of regarding the claimant, and generated at any time on or after the Date of Incident for the alleged accident/illness/injury/incident at issue, have been included as part of this submission of a proposed amount for a Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) to the Centers for Medicare and Medicaid Services.”
As was true with the prior statement released on May 14, 2010, The CMS goes onto to state that they will not accept any variations of this latest statement. If a WCMSA proposal is submitted without this exact wording, they will not accept the rated ages provided and will estimate the claimant’s remaining life expectancy using actual age. The CMS will continue to accept WCMSA proposals using the previous wording up to and including June 30, 2010. All other requirements of acceptable proof of a rated age remain unchanged.
To view this latest memo, please click here.
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CMS Announces Direct Data Entry Option |
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Industry News Updates
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Tuesday, 22 June 2010 14:00 |
Written By: Tom Matson
The Centers for Medicare and Medicaid Services (CMS) recently announced a more effective reporting option for “small reporting” Responsible Reporting Entities (RREs). This new method, referred to as the Direct Data Entry (DDE) Option, is only available for those RREs who will be reporting 500 or fewer claim reports per calendar year.
Those RREs that are able to utilize this DDE Option will be able manually enter and submit their data rather than submit an electronic file over the Section 111 Coordination of Benefits Secure Website (COBSW). Small reporters may register for DDE as a reporting option beginning October 1, 2010. If an RRE has already registered under the current methods, the Account Manager for the RRE will be able to change their reporting method on or after October 4, 2010. These small reporters will be able to begin reporting using this DDE option on January 3, 2011.
The CMS goes on to state that there will be no testing period required for RREs using the DDE option, and claim information should be submitted one claim at a time “as soon as conditions related to the claim require reporting under Section 111.” Also, those small reporters using the query system should be aware that if an injured party’s information does not match up to a Medicare beneficiary during the DDE process, it WILL count toward the RREs limit of 500 claims per year.
It is important to note that RREs utilizing the DDE option have the same responsibilities as any other RREs. While this does provide an easier alternative for those RREs that have a very limited number of claims to support, those RREs that are borderline should take precautions to assure that they do not exceed the 500 claims per year limit.
To view this latest memo in its entirety, please click here.
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CMS Offers Clarity to Use of Non-Covered Part D Drugs and Rated Ages |
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Industry News Updates
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Saturday, 15 May 2010 14:21 |
By: Tom Matson
On May 14, 2010, the Centers for Medicare and Medicaid Services (CMS) issued a new memo that attempts to clarify the use of non-covered part D drugs in a Workers Compensation Medicare Set Aside Arrangement (WCMSA). Per this latest memo:
1) Effective June 1, 2010, workers’ compensation cases that are settled prior to June 1, 2010, and include non-covered Part D drugs as part of the WCMSA, CMS will consider funds spent for those non-covered Part D drugs as being an appropriate expense from the WCMSA.
2) For those workers’ compensation claims that are not settled prior to June 1, 2010, and also include non-covered Part D drugs as part of the WCMSA, CMS will consider a re-pricing of those cases. Once the re-pricing has been completed, the claimant may not use the funds from their WCMSA to pay for non-covered Part D drugs.
3) For those workers’ compensation cases settled on or after June 1, 2010, and where the settlement does not include non-covered Part D drugs as part of the WCMSA, claimants may not use funds from their WCMSA to pay for those non-covered Part D drugs.
This memo also rescinds the previous rated age statement that stated “all rated ages obtained on the claimant have been included”. The new language regarding rated ages that must be included on all submissions reads as follows:
“Our organization certifies that all rated ages obtained on the claimant, at any time during that individual claimant’s lifetime, have been included as part of this submission to the Centers for Medicare & Medicaid Services.”
This latest memo goes onto state that the CMS will not accept any variations of this language, and that this language must be included without exceptions. If this language is not included than the CMS will not accept the rated age provided and will estimate the claimant’s remaining life expectancy using Actual Age. All previously released information on the use of rated ages for a claimant remain unchanged, and acceptable proof of rated ages is demonstrated through inclusion of independent rated ages on the letterhead of an insurance carrier or settlement broker.
To view this memo in it’s entirety, please click here. |
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