February 2012

Updated Information- Workers' Compensation Review Contractor Files a Second Bid Protest

You may recall in our September 2011 and July 2011 newsletters, the Centers for Medicare and Medicaid Services (CMS) reported that they had provided a new Workers' Compensation Review Contractor (WCRC) award to Provider Resources, Inc. of Erie, Pennsylvania for Medicare Set Aside administration. Subsequently, the current contractor, Data and Analytic Solutions, Inc., filed a bid protest on July 5, 2011 that was dismissed on August 3, 2011.

In response to the dismissal, Data and Analytic Solutions, Inc. filed a second bid protest on November 23, 2011 to overturn the CMS award. The Government Accountability Office is due to make a final decision on the second bid protest on March 2, 2012. The WCRC is the only national reviewer of Workers' Compensation Medicare Set-Aside WCMSA proposals in the country for CMS.

CMS Publishes Quick Reference Guide 1.0 for Responsible Reporting Entities

The Centers for Medicare and Medicaid Services (CMS) has published their Quick Reference Guide for Non-Group Health Plan Responsible Reporting Entities (NGHP) on January 19, 2012.

Understanding Your Medicare Benefits and Medicare Set-Asides

Each year the Department of Health and Human Services (HHS) publishes their updated Official U.S. Government Medicare handbook with important information for Beneficiaries to know. When Medicare Set-Asides are completed for insurance claims, a Beneficiary must preserve his/her Medicare Benefits by setting aside a portion of the settlement money in a segregated interest bearing account to pay for future Medicare covered benefits. Once the Medicare Set Aside account is exhausted, with the understanding that the Beneficiary has complied with all requirements under the law, then full Medicare coverage is provided for any Medicare covered healthcare.