Does a “system of records” exist for the documentation that CMS receives and or collects concerning the proposed Medicare Set-aside?
A23. Yes. CMS’ Division of Benefit Coordination is in the process of establishing a “system of records” via the Federal Register process, which will provide legal authority to maintain records on injured parties that are not enrolled in Medicare. The CMS Regional Office will be responsible for maintaining or “housing” the records for every Medicare Set-aside in which CMS provides a written opinion. Please note that these records are not subject to Freedom of Information Act requests and may not be disseminated to the public. Q24. What types of measures should CMS and the contractors take to ensure that Medicare makes no payments for work or accident related injury or illness medical services and prescription drug charges until the Medicare Set-aside has been properly exhausted? A24. If the contractor monitoring the injured party’s case discovers that payments from the Medicare Set-aside have been used to pay for medical services or prescription drug charges that are not covered by Medi
Related Questions
- Are there documentation requirements that must be satisfied before CMS can provide a written opinion on the sufficiency of a Medicare Set-aside?
- Does a "system of records" exist for the documentation that CMS receives and or collects concerning the proposed Medicare Set-aside?
- What is the referral process for submission of a proposed Medicare Set-aside to CMS?
