Our Insights

Author: Sherrie Allen, Vice President of Clinical Services   🚨 The Case of the Unnecessary Transplant Picture this: A middle-aged woman with post-COVID cardiac complications. A shocking recommendation for a heart transplant buried in her records. A price tag of millions added to her Medicare Set-Aside (MSA). But here’s the twist: the suggestion came from […]

Author: Michelle Allan, Principal   Already off to a hot year in WCMSA updates, CMS kicks off Q2 with another round of new information for the Medicare Secondary Payer community. Workers’ Compensation Medicare Set-Aside Reference Guide Version 4.3 published April 7, 2025 serves up the awaited language associated with the Amended Review timeframe elimination, as […]

Author: Carolyn McKaige   All the talk these days of CMS eliminating waiting periods for Amended Review of an MSA has cast a shadow on its predecessor – the Re-Review process. If you get a result from CMS and don’t want to bite the one-time Amended Review apple just yet, Re-Review is alive and well […]

The Zero Dollar Medicare Set-Aside: A Budget-Friendly Mystery Let’s talk about a little-known gem in the world of Medicare set-asides: the infamous zero dollar set-aside. Now, you might be wondering, “What in the world is a zero dollar Medicare set-aside?” A zero dollar set-aside is when it is determined that, after careful analysis, you don’t […]

Attention all workers’ compensation carriers! Are you ready to revolutionize how you handle Medicare set-asides in nuisance value cases? Say goodbye to the old, cumbersome processes and hello to our innovative MSA111 product, designed specifically to help you plug the gaps and streamline your compliance efforts. 🌟 Why MSA111?  If you’re settling cases with a Medicare beneficiary and […]

Indemnified Medicare Set-Asides:  A Dangerous Deal for Carriers, Beneficiaries, and Taxpayers  What You Need to Know Before You “Buy” In The market for guaranteed Medicare Set-Aside arrangements in workers’ compensation cases remains complex and often opaque. This complexity has unfortunately created opportunities for products promising simplicity and cost savings, but which may carry substantial risks. […]