Are there documentation requirements that must be satisfied before CMS can provide a written opinion on the sufficiency of a Medicare Set-aside?
A44. Yes. CMS has provided a checklist of requirements that are necessary to conduct a review of the proposed Medicare Set-aside which can be found at: http://www.cms.hhs.gov/WorkersCompAgencyServices/Downloads/wcchecklist.pdf At a minimum, the following documentation must be submitted to CMS prior to the approval of any Medicare Set-aside. 1. Injured party=s name 2. Injured party=s date of birth 3. HICN (Medicare health insurance claim number) or SSN (Social Security number) if the injured party is not yet entitled to Medicare 4. Injured party=s address or telephone number 5. Injured party=s signed CMS Consent to Release authorization (Q10) 6. Name of injured party= attorney=s name, address and telephone number 7. Name of workers= compensation carrier=s= attorney=s name, address and telephone number 8. Entitlement information. Indicate if the injured party is currently enrolled in Parts A, B or D. Attach a copy of the injured party=s Medicare card. If the injured party is not currentl
Related Questions
- Are there documentation requirements that must be satisfied before the CMS Regional Office can provide a written opinion on the sufficiency of a Medicare Set-aside?
- Does Medicare give written advance advisory opinions on the sufficiency of a Medicare Set-aside even if the injured party is not as yet entitled to Medicare?
- Does a "system of records" exist for the documentation that CMS receives and or collects concerning the proposed Medicare Set-aside?
