Workers' Compensation Medicare Set-Aside (WCMSA)

9/11/2023 - 33 min read

The Minnesota Supreme Court rules that a TPLF agreement’s 60% “repurchase rate” is not subject to MN’s usury statute; remands case back to the district court to determine if this rate is “unconscionable” (and, thus unenforceable) under common-law

One of the issues regarding TPLF concerns whether the interest rates charged by litigation funders can be considered excessive, or legally unenforceable.

8/30/2023 - 1 min read

Verisk Casualty Solutions attends 77th Annual WCI Conference in Orlando, Florida!

Last week Verisk Casualty Solutions proudly attended the 77th Annual Workers' Compensation Educational Conference and 34th Safety & Health Conference in Orlando, FL!

8/8/2023 - 9 min read

CMS releases NGHP User Guide (Version 7.3) – updates include changes to the ORM trigger and CMS’s Unsolicited Response File process

The (CMS) has released an updated Section 111 NGHP User Guide (Version 7.3, August 7, 2023) regarding Section 111 reporting related to non-group health plans

1/9/2023 - 7 min read

CMS releases request for proposal for the Workers’ Compensation Review Contractor (WCRC) contract

On January 4, 2023, the Centers for Medicare and Medicaid Services (CMS) issued an RFP for its Workers’ Compensation Review Contractor (WCRC) contract.

11/3/2022 - 10 min read

CMS releases data and statistics regarding CRC recoveries and WCMSAs

The Centers for Medicare and Medicaid Services (CMS) has released two new reports providing data regarding CRC recoveries and WCMSAs.

2/18/2022 - 12 min read

CMS holds WCMSA webinar CMS discusses non-submit/EBMSAs, allocation pricing, denials, and other important WCMSA topics

On February 17, 2022 the Centers for Medicare and Medicaid Services (CMS) held a webinar session to address workers’ compensation Medicare set-aside (WCMSA) issues.

1/13/2022 - 5 min read

New Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5) takes aim at non-submit and EBMSAs

Centers for Medicare and Medicaid Services (CMS) has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5, January 10, 2022).

3/12/2021 - 4 min read

The COMP Act is reintroduced in the U.S. Senate

On 3/10/21, Senators Ben Cardin (D-MD) and Rob Portman (R-OH) introduced the Coordination of Medicare Payments and Workers’ Compensation Act (COMP Act) (S. 653) into the United States Senate.

10/6/2020 - 1 min read

CMS releases new WCMSA Reference Guide (Version 3.2)

On 10/5/20, CMS released its latest version of the WCMSA Reference Guide, Version 3.2. This guides replaces version 3.1, released on 5/11/20.

3/30/2020 - 9 min read

Settling claims in unsettling times

In a time of social distancing and uncertainty, many are left wondering how our current working and social paradigm will impact workers’ compensation claims handling – especially being able to close claims.

11/8/2019 - 4 min read

CMS holds webinar on WCMSA Electronic Attestations for Professional Administration

On 11/6/19, CMS held a webinar on Workers’ Compensation Medicare Set-Aside (WCMSA) Electronic Attestation Enhancement for Professional Administrators.

11/1/2019 - 4 min read

CMS holds webinar on WCMSA Electronic Attestations for Self-Administered Accounts

On 10/30/19, CMS held a webinar to discuss recent enhancements to the Workers’ Compensation Medicare Set-Aside Portal (WCMSAP).

10/31/2019 - 6 min read

CMS releases new WCMSA Reference Guide (Version 3.0)

CMS has released a revised Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.0, October 10, 2019).

10/18/2019 - 3 min read

CMS releases WCMSA Self-Administration Toolkit 1.3

CMS has released the latest edition of its Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements (Version 1.3; October 10, 2019).

10/11/2019 - 8 min read

Ninth Circuit: CIGA is not a “primary payer” under the MSP and does not have to reimburse Medicare

In a significant new case out of California, the United States Circuit Court of Appeals (Ninth Circuit)[1] in California Insurance Guarantee Association (CIGA) v. Azar, 2019 WL 5076945 (9th Cir. Oct. 10, 2019) reversed the United States District Court for the Central District Court of California [2] and ruled that CIGA is not a “primary plan” under the Medicare Secondary Payer (MSP) statute and, therefore, not liable to reimburse Medicare conditional payments made on behalf of workers’ compensation claimants.