The Centers for Medicare & Medicaid Services (CMS) issued a statement on December 21, 2016, advising that in 2017 it expects to update its process for re-review of previously approved Medicare Set-Asides. Specifically, CMS expects to update its existing re-review process to address situations in which CMS had approved a set-aside, however, settlement did not occur, and that medical care supporting the approved amount has changed dramatically. CMS also expects the updates to address situations in which states rely upon the Utilization Review processes to justify proposed Workers' Compensation Medicare Set-Aside Arrangements (WCMSA) amounts.
We will continue to monitor the progress of Medicare's review process and provide you with updates as they become available.
For more information, please contact Renee M. Porada Frazier at firstname.lastname@example.org or 412.281.4573.