On November 6th, the Centers for Medicare and Medicaid Services (CMS) held an informational webinar entitled Workers’ Compensation Medicare Set-Aside (WCMSA) Electronic Attestation Enhancement for Professional Administrators.
CMS hosted this webinar to discuss recent enhancements to the Workers’ Compensation Medicare Set-Aside Portal (WCMSAP) and comes on the heels of its October 30th webinar where the agency discussed these new enhancements in the context of self-administration. See our recent article summarizing CMS’ October 30th webinar.
In a nutshell, CMS will now allow Medicare beneficiaries (or their representatives) to submit their required annual attestations electronically for approved WCMSAs through the WCMSAP. Up until recently, the administrator had to submit these filings via mail.
Webinar: Key Highlights
The primary goal of the webinar was to demonstrate the functionalities added to the WCMSAP that were outlined in the updated WCMSAP User Guide with regard to professional administrators of the WCMSA account.
Among the main functions CMS demonstrated on the webinar included:
- Registration and account set-up. CMS noted that companies with existing corporate accounts with the WCMSAP will still need to create a separate professional administration account.
- Viewing and accessing files. In relation to this, CMS noted that where the WCMSA submitter provides CMS with the professional administrator’s information during submission, it will automatically link the file to that applicable administrator’s company account when the claim settles, and settlement documents are provided to CMS. The professional administration company is also able to upload document supporting their link to the case as well.
- Requesting Access to Files previously submitted to CMS. Per CMS, the professional administrator is required to submit a starting balance that is current as of the date of the request.
- Uploading annual attestations and account statements. Professional Administrators can now submit a bulk file for all claims they are administering. The WCMSAP User Guide lays-out file requirements. A company can submit a maximum of 500 files per year.
- Viewing MSA balance. This is an important feature, because it allows the professional administration companies to identify where there is a discrepancy between CMS and their account, so that those issues can be addressed quicker.
In addition to the above, CMS also walked through a couple of key new functions for corporate accounts for WCMSA submitters. Specifically, CMS discussed the ability to indicate who is administering the account. CMS also advised that the default is self-administration, although both the representative payee and professional administration options are also available but would need to be selected. Also, and importantly, CMS reminded the attendees that when professional administration is selected the full information about the professional administration company is required including an agreement, or proposed agreement, between the claimant and the professional administration company. In addition, CMS advised a new contract needs to be submitted when there is a change in professional administrator.
One major point CMS stressed throughout the webinar was the importance of ensuring that settlement documents are submitted when a claim is settled. While the filing of settlement documents with CMS has long been required to close-out a case with CMS, the agency stressed that without the settlement documents, the claim is considered open and professional administrator will not have access to provide regular attestations on the claim.
Recap of other recent and related CMS items
In addition to CMS November 6th webinar outlined above, CMS has been quite active in issuing changes around WMCSA administration and other MSA related items.
Here is quick recap of other recent CMS related items:
CMS October 30th Webinar – Self Administration
As noted above, CMS held a webinar for self-administered accounts in which the agency walked the participants through how to access and submit annual attestations electronically. CMS also demonstrated features available to injured workers where they can review prior filings and check their MSA balances among other features. We provided a recap which discusses this webinar in more detail.
Prior to the October 30th webinar, CMS released an updated version of their self-administration Toolkit which designed to help injured workers, or their representatives, administer their MSAs. These updates centered on the new ability for self-administrators to submit their annual attestations electronically, along with updates regarding inheritance of WCMSA funds to mirror the language contained in CMS’ WCMSA Reference Guide. We covered these changes in a recent article.
Updated WCMSA Reference Guide
CMS also recently updated its WCMSA Reference Guide. The major items updated through the new Reference Guide involved updating the language regarding annual attestations to account for the new electronic submission option, expanding the Amended Review option to challenge WCMSA decisions from four to six years, and changes to the consent to release form effective in April 2020. Our recent article outlines these and other updates made by CMS.
Do not hesitate to contact us if you would like additional information or assistance with determining the ideal type of administration for your claim. I can be reached directly via email at email@example.com or via phone at 978-825-8232 if you have any questions on the above information.