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June 07, 2018
Mike Merlino
SVP Medicare Compliance
Generic vs. brand name prescription drug costs – how much could you save?

About three years ago, we posted the article, “Could you cut $185,000 from your MSA?” The crux of this article was that by simply changing one drug from brand name to generic, you could save $185,000 from the cost of a Medicare Set-aside (MSA). …

June 07, 2018 by Mike Merlino, SVP Medicare Compliance
September 18, 2017
Mike Merlino
SVP Medicare Compliance
Centers for Medicare & Medicaid Services (CMS) retains new review contractor

On September 1, CMS hired Capitol Bridge, LLC to be the new review contractor for MSAs. According to CMS employees that we’ve spoken to, the transition is currently underway. The old contractor is staying on for an indeterminate amount of time to h…

September 18, 2017 by Mike Merlino, SVP Medicare Compliance
July 14, 2017
Mike Merlino
SVP Medicare Compliance
MSAs: A second bite at the apple

CMS now permits some old MSAs to be re-approved Before this week, the Centers for Medicare & Medicaid Services (CMS) had a simple philosophy: Parties get one bite at the apple when it comes to CMS approval. However, on Monday, CMS released an upda…

July 14, 2017 by Mike Merlino, SVP Medicare Compliance
November 04, 2016
Mike Merlino
SVP Medicare Compliance
CMS rescinds changes to zero dollar MSAs- for now

Last week I posted that CMS appeared to have altered the zero dollar MSA approval process. This caused a great deal of discussion and activity. This has resulted in CMS releasing the following bulletin indicating that no  changes …

November 04, 2016 by Mike Merlino, SVP Medicare Compliance
October 28, 2016
Mike Merlino
SVP Medicare Compliance
CMS appears to have altered zero dollar MSAs approval process

For the past several years, we have been successful in obtaining zero dollar MSAs approved by the MSA review contractor. The case, however, had to meet very strict criteria: The case was denied; There had to be no payments for indemnity; There…

October 28, 2016 by Mike Merlino, SVP Medicare Compliance
January 21, 2015
Mike Merlino
SVP Medicare Compliance
Could you cut $185,000 from your MSA?

What if I told you that you could save $185,000 at no cost to you? No, I am not advertising for some late night TV infomercial where the offer is too good to be true. I am talking about the world of Medicare set-asides (MSA). It is well known that pr…

January 21, 2015 by Mike Merlino, SVP Medicare Compliance
October 30, 2014
Mike Merlino
SVP Medicare Compliance
Change, non-change important to Medicare compliance regulations

If you have been trying to keep up with the latest Medicare compliance changes, you might feel like you are watching the carnival vendor who used to say, “around and around it goes and where it stops nobody knows.” Fortunately, with these answers y…

October 30, 2014 by Mike Merlino, SVP Medicare Compliance
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