Workers' Compensation Medicare Set-Aside (WCMSA)

7/14/2025 - 8 min read

TPOC/WCMSA Reporting is Underway – Unexpected Issues and Considerations

Based on our handling of MSP claims and observations, we note these considerations and issues where further CMS clarity may be helpful.

6/20/2025 - 9 min read

CMS discusses general WCMSA compliance points on its June 17th webinar

On June 17th, the Centers for Medicare and Medicaid Services held an “Introduction to Workers’ Compensation Medicare Set-Asides (WCMSAs) Webinar.”

6/9/2025 - 1 min read

Starting June 14, 2025 CMS Will Use the 2022 CDC Life Table for WCMSAs

CMS has announced that it will use the “Table 1: Life Table for the total population: United States, 2022” to calculate an adjusted life expectancy.

6/2/2025 - 1 min read

CMS to Hold Intro to WCMSAs Webinar – June 17th at 2:00 p.m. ET

CMS has announced that it is holding an Introduction to workers’ compensation Medicare set-asides Webinar scheduled for June 17th at 2:00 p.m. (ET).

5/15/2025 - 12 min read

CMS’s New $0 WCMSA Policy Starts 7/17/25 – Key Points and How Verisk Can Help

Major changes are coming to $0 Workers’ Compensation Medicare set-asides (WCMSA) practices starting in July 2025.

5/7/2025 - 4 min read

CMS Releases Section 111 NGHP User Guide (Version 8.1)

CMS has released an updated Section 111 NGHP User Guide (Version 8.1, May 5, 2025) regarding Section 111 reporting related to non-group health plans.

4/25/2025 - 2 min read

Colorado Delays Release 3.1 for FROI/SROI Reporting Until 7/30/2026

The DOWC announced it is delaying its implementation of Release 3.1 for FROI/SROI reporting. The transition has been delayed until 7/30/2026.

4/23/2025 - 3 min read

CMS Releases Updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide (Version 6.5)

CMS has released an updated MSPRP User Guide Version 6.5 (April 7, 2025) featuring several updates.

Office Working Concentrating On Laptop Screen Article

3/19/2025 - 5 min read

A New Day for WCMSA Amended Review Requests Start April 7th

Effective April 7, 2025, CMS will permit Amended Review requests any time after a WCMSA case approval.

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.