MSA Plus is certified as a women’s business enterprise through the Women’s Business Enterprise National Council (WBENC), the nation’s largest third party certifier of businesses owned and operated by women in the US.  

We recognize the commitment to supplier diversity that is embraced by corporations and government agencies today, and we can add diversity to your supply chain.

WCMSA Reference Guide Version 2.3, Released on 01/05/15. 

Changes can be found in 1.1 and include:

1.  Updated language to correspond with recent changes to letters.

      • Corrected reference from 42 CFR 411.46 to Section 1862(b)(2) of the Social Security Act.
      • Clarified reference to costs related to the workers’ compensation claim, rather than the compensable injury.
      • Clarified reference to future medical items and services as “Medicare covered and otherwise reimbursable.”
      • Clarified that CMS approves the WCMSA amount, not the WCMSA, upon submission of a request.
      • Correspondingly, clarified language referring to submission of a proposed WCMSA amount, rather than a WCMSA proposal.
      • Restated the comparison of fee-schedule vs. full-and-actual-costs pricing as the basis of pricing the proposed amount, rather than the basis of payment from an approved WCMSA account.
      • Clarified attestation vs. accounting wording.
      • Clarified procedural results when Medicare is not provided with information in response to a development request.
      • Removed the word “form” from references to documents that are not forms.

2.  Added language to address schedule change for hydrocodone compounds from schedule III to schedule II. See Section 9.4.6.2.

3.  Changed deadline for responding to development requests for submission through the WCMSA Portal to 20 from the previous 10 days. See Sections     9.4.1 and 9.5.

The most significant impact on the day to day operations with CMS will come from items 2 and 3.

Added language to address schedule change for hydrocodone compounds from schedule III to schedule II. See Section 9.4.6.2

Hydrocodone combination products were reclassified to C-II controlled substances.  C-IIs require new prescriptions at intervals no greater than 30 days; however, a practitioner may issue up to three consecutive prescriptions in one visit authorizing the patient to receive a total of up to a 90-day supply of a C-II. WCMSA guidelines changed on January 1, 2015 for all new cases submitted after that date to allocate a minimum of 4 healthcare provider visits per year when schedule II controlled substances (including hydrocodone combination products) are used continuously, unless healthcare provider visits are more frequent per medical documentation.

Although CMS has been allocating four visits per year for ongoing monitoring of medication, the final statement indicates that additional visits may be allocated when records indicate a trend of more frequent visits.  MSA Plus identifies these trends so steps can be taken to implement the 90-day prescription authorization in an effort to minimize this potential cost driver and reduce the number off office visits.

Changed deadline for responding to development requests for submission through the WCMSA Portal to 20 from the previous 10 days. See Sections 9.4.1 and 9.5:

The five most frequent reasons for development requests by the WCRC:

1. Insufficient or out-of-date medical records;
2. Insufficient payment histories, usually because the records do not provide a breakdown for medical, indemnity, or expenses categories;
3. Failure to address draft or final settlement agreements and court rulings in the cover letter or elsewhere in the submission;
4. Documents referred to in the file are not provided—this usually occurs with court rulings or settlement documents;
5. Submissions refer to state statutes or regulations without providing sufficient documentation, i.e., a copy of the statute or regulation, or notice of which statutes or regulations apply to which payments.

MSA Plus provides a comprehensive review of all the medical records prior to submission, identifying any potential gaps in treatment or missing information.  Once this information is identified, we make every attempt to obtain it prior to submission in order to mitigate the chance of a development letter and/or delayed CMS turnaround times.

 

September 2014 - Attended the LCP Conference in Minnesota.  Excellent presentations that were educational and applicable to life care planners in all areas of practice.

 

 

August 2014 - Attended the GBAALNC Conference in Birmingham, AL.  Great networking opportunity with other local AALNC's as well as many participants that were checking out becoming a legal nurse consultant and the many different opportunities available.  The presentations were educational and applicable to legal nurse consultants in all areas of practice.

 

 

May 2014 - Attended the NAMSAP conference in Las Vegas, NV.  Excellent and up-to-date information and resources provided for an ever-changing industry. Great networking opportunities.  Joined the Evidence-Based Medicine Committee and looking forward to working with the group.

 

 

April 2014 - Attended the AALNC conference in Denver, CO.  Sessions were very informative and relevant to ongoing Legal Nurse reviews in all areas.  Great opportunity to see old friends and make new ones!  Joined the Webinar Committee and looking forward to working with a great group of professionals that will assist in providing resources to other Legal Nurse Consultants.

 

 

MSA Plus is pleased to offer File Reviews to assist with closure of older workers' compensation claims. A file review utilizes all the skills of a nurse, a case manager, a life care planner, and a legal nurse reviewer, as well as someone who is knowledgeable in medicare set-asides and the medicare secondary payer process in order to get you the best possible results on your files.

 

A file review is the first step in progressing towards case closure.

msa-thumbAfter months of preparation and planning the new MSA Plus.com website has been launched. We are very excited at the new look and hope that our users find it easy to navigate and use.

The custom MSA Plus Referral Form has been designed for ease of use as well as security of information. Once the data has been submitted, the client will receive an outline of the submitted data in an easy to read pdf automatically within seconds of submission. At MSA Plus we feel that attention to details like this is just another reason to utilize the professional services MSA Plus has to offer.