The Centers for Medicare & Medicaid Services expects to update in the new year its re-review process to address situations where CMS has approved a Medicare set-aside amount, but settlement has not yet occurred and medical care in the claim has changed substantially.
CMS also expects its updated process to address situations where certain states rely on utilization review procedures to justify proposed set-aside amounts, the agency announced last week.
The announcement may be good news for employers, carriers and claimants who have been frustrated when CMS won’t ...
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