Workers' Compensation Medicare Set-Aside (WCMSA)

1/23/2025 - 5 min read

CMS will end one-year waiting period to file WCMSA Amended Review requests

CMS has a released an Alert advising that effective 4/7/2025, Amended Review requests “will be allowed at any time a WCMSA case is approved.”

1/22/2025 - 11 min read

CMS releases WCMSA Reference Guide 4.2-CMS to end review of $0 WCMSAs

CMS releases an updated WCMSA Reference Guide (Version 4.2, January 17, 2025).

Office Working Concentrating On Laptop Screen

12/11/2024 - 8 min read

New Section 111 NGHP User Guide (Version 7.8) – CMS adds new section regarding WCMSAs

CMS released an updated Section 111 NGHP User Guide (Version 7.8) regarding S.111 reporting related to non-group health plans.

10/22/2024 - 7 min read

WCMSA submission remains voluntary, leveraging EBMSAs to settle claims

With CMS’s plans to collect WCMSA reporting data through Section 111 TPOC reporting, it may be a good time reconsider the EBMSA landscape.

10/16/2024 - 4 min read

Decimal Extension for Loss Costs and Rates are on the Horizon

The EDI & WCIO have discussed a change on how loss costs and rates are filed.

10/16/2024 - 4 min read

Verisk’s Data-Driven MSA: A Solution for Low-Dollar TPOC/WCMSA Reporting

Manage low-dollar workers’ compensation settlements ($25,000 or less) for Medicare beneficiaries under CMS’s updated process.

10/11/2024 - 17 min read

CMS releases Section 111 NGHP User Guide (Version 7.7)

CMS released an updated Section 111 NGHP User Guide for reporting on non-group health plans: liability, no-fault, and workers' comp.

9/25/2024 - 13 min read

Voluntary testing for TPOC/WCMSA reporting starts October 7, 2024

Reminder for Section 111 NGHP RREs: CMS’s voluntary testing for the new TPOC/WCMSA reporting starts October 7, 2024.

9/11/2024 - 4 min read

Are Your WCMSA Protocols Being Followed? How Verisk’s MSA Link Can Help

CMS’ new process will require insurers to report several WCMSA data points as part of settlements involving Medicare beneficiaries.

8/21/2024 - 2 min read

New WCMSA Self-Admin Tool Kit – CMS updates on MAP and Part D plans

CMS releases updated WCMSA Self-Administration Tool Kit (v1.6), with key updates on Medicare Part C, MAP, and Part D plans.

8/21/2024 - 6 min read

New WCMSA Reference Guide (V 4.1) focuses on Medicare Advantage and Part D

CMS' new WCMSA Reference Guide (v4.1) outlines WCMSA coordination with other health insurers.

7/30/2024 - 5 min read

Spotlight on WCMSAs – Nutshell Resource

How to prepare for CMS’ new TPOC reporting requirements – Nutshell resource summary.

7/30/2024 - 15 min read

Spotlight on WCMSAs - preparing for CMS' new TPOC reporting requirements

Starting April 4, 2025, CMS requires Section 111 RREs to report specific WCMSA data for all Medicare beneficiary settlements in TPOC reporting.

7/18/2024 - 2 min read

Mid-Year “Round-Up” 2024 – tracking Medicare and claims updates

Stay updated on 2024’s key claim trends: Medicare changes, Section 111 penalties, TPOC/WCMSA reporting, MSAs, FROI/SROI, TPLF, and more.

4/15/2024 - 1 min read

CMS releases WCMSA Reference Guide Version 4.0

CMS has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 4.0, April 1, 2024).