September 25, 2017 • Compliance

Medicare Set Aside Take-Aways: CMS Train the Trainer Workshop

Centers for Medicare & Medicaid National Train the Trainer Program: What We Learned

In the world of Medicare Set Aside account administration, we encounter questions on Medicare, CMS compliance and Social Security Administration programs on a regular basis. We are subject matter experts in the world of Medicare Secondary Payer, but we also stay up to date with the latest Medicare changes as well.

This year we attended the CMS National Train the Trainer workshop in Portsmouth, New Hampshire to talk to and work directly with Medicare Professionals and representatives from CMS.

We learned a lot from the Train the Trainer workshop, and we want to share our new knowledge with you!

Here are some important take-aways that are beneficial to remember for the future:

  • Medicare prescription drug formularies can and do change periodically
  • Medical Marijuana is not covered by Medicare, and no official guidance has been given on when that might change. While it is legal in certain states, this would represent an out of pocket cost and MSA funds cannot be used for any of these products.
  • We provide full coordination of benefits services to ensure payment obligations are addressed if MSA funds are exhausted. It is important we know of your secondary insurance, Medicare Advantage, VA Benefits or other program or policy you belong to as a member.

Of particular interest to us was what Medicare does and does not cover, the changes and updates to the Medicare Prescription Drug Formulary, and Medicare’s coordination of benefits to determine who pays what and when.

One of the reasons we focus so intently on keeping up to date with all of the changes involving Medicare is to adhere to the requirements to consider Medicare’s interest in professional MSA account administration. Non-compliance with this obligation can jeopardize an injured party’s future with their Medicare benefits.

In our previous blog posts, we’ve discussed how we are focused on providing the best quality healthcare coordination, but we’re also focused on the future to ensure your benefits are intact and maximized.

The Medicare world can be confusing at times, but we are here to help answer your questions or connect with your local State Health Insurance Assistance Program counselor to get you the right answer.

Have questions? We can help, contact us at 877.275.7415 or referral@ametros.com.

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