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

Posted March 20, 2018

On March 19, 2018, CMS announced a new Version 2.7 of the Workers’ Compensation Medicare Set-Aside Arrangement Reference Guide.  The Reference Guide can be found here.  Overall, there are no significant changes in the newest version.

CMS Announces Consideration for Expansion of Medicare Set-Aside Arrangements

Posted October 31, 2017

CMS has announced that it will continue to consider expanding its voluntary MSA review process to include both liability and no-fault MSAs.  CMS has also stated that it will work closely with interested parties to determine the best way to implement the expansion of voluntary MSA reviews. It was reported last month that a new […]

Latest WCMSA Reference Guide “Highly Recommends” Professional MSA Administration

Posted August 10, 2017

CMS has recently indicated their support for the professional administration of Workers’ Compensation Medicare Set-Aside Arrangements.  CMS has never opposed professional administration, however, this is the first time where they have specifically stated that professional administration is the preferred path.  This recommendation comes from the latest WCMSA Reference Guide Version 2.6. In Section 17.1 of […]

Revisions to WCMSA Reference Guide

Posted August 2, 2017

CMS’ re-review process has undergone recent changes. The change was formallyannounced through a revised Workers’ Compensation Medicare Set-Aside Portal (WCMSAP) User Guide. The new re-review option became available and effective as of July 31, 2017. In order to exercise the re-review option, the following thresholds must be met: The MSA must have been originally submitted […]

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

Posted August 1, 2017

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 […]

CMS Switches to 2012 Life Table

Posted March 12, 2017

As of April 1, 2017, CMS has begun utilizing the CDC’s Table 1: Life Table for the total population: United States, 2012. Therefore, any WCMSA proposal received by CMS, or where any WCMSA case is reopened on or after April 1, 2017, CMS will apply the CDC’s 2012 Table 1 to calculate life expectancy. The […]

Shift from MRI Scans to CT Scans in WCMSAs for Claimants with Intrathecal Pumps

Posted January 14, 2017

In WCMSAs, it has become the standard to substitute CT scans in place of MRI scans for claimants with intrathecal pumps. Intrathecal pumps are implanted programmable battery powered devices comprised of a pump and catheter in which medication is dispensed and carried directly to the spinal fluid (intrathecal space). In this method, less medication is […]

The Effect of Thresholds on Mandatory Reporting

Posted December 14, 2016

Last year, CMS announced a change in reporting thresholds to $750 for liability settlements, and advised that it would maintain the $750 threshold for no-fault and workers’ compensation settlements, so long as the insurer or entity does not otherwise have ongoing responsibility for medicals (ORM). In 2017, CMS issued a number of alerts and announcements, […]

Liability and No-Fault Medicare Set-Aside Allocations

Workers' Compensation Medicare Set-Aside Allocations