New Workers’ Compensation Medicare Set-Aside Arrangement Reference Guide Issued

Posted August 1, 2017

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CMS has announced that Version 2.6 of the Workers’ Compensation Medicare Set-Aside Arrangement Reference Guide is now available.  The Reference Guide can be found here.   One of the more important updates to the Reference Guide is the expansion of criteria for the re-review of a WCMSA.  Essentially, the update states that submitters can submit a re-review request of a WCMSA where CMS has already approved an amount so long as settlement has not occurred and the medical care (services of medications) has changed substantially.  This is a very important update because medical care is ever-changing.  Allowing for the re-review of an approved WCMSA is positive for all parties involved.  The chance to project for the correct amount of set-aside funds is now more likely.