Workers' Compensation Medicare Set-Aside (WCMSA)
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).
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).
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).
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,…
CMS releases WCMSA Portal User Guide Version 5.9
On 10/7/19, CMS released the latest edition of its Workers’ Compensation Medicare Set-Aside Portal User Guide (WCMSAP) (Version 5.9).
CMS will use the 2016 CDC Life Table for WCMSAs starting 10/12/19
On 9/12/19, CMS announced beginning 10/12/19, it will use the new 2016 CDC Life Table to calculate adjusted life expectancies in WCMSAs.
WCMSA RX update – FDA approves first generics of Lyrica
On 7/22/19, the FDA announced it approved the first generics of Lyrica. This comes at a critical time as CMS has increasingly been including Lyrica in WCMSAs
Georgia senate bill 135 adds exceptions to the 400 week limit for future medicals – Overview and WCMSA impact
Georgia Senate Bill 135 (SB 135) was signed into law on May 7, 2019 and makes notable changes to Chapter 9 of Title 34 of the Official Code of Georgia Annotated related…
CMS to mask health insurance claim number and social security number on contractor correspondence starting April 2019
Starting 4/1/19, CMS’s Coordination of Benefits and Recovery Program program will mask the social security number (SSN) and SSN-portion of the health insurance claim…
CMS releases new WCMSA Reference Guide (Version 2.9)
On 1/4/19, CMS released their latest version of the WCMSA reference guide Version 2.9.
CMS will use the 2015 CDC Life Table for WCMSAs starting 1/5/19
In an alert dated December 5, 2018, the Centers for Medicare and Medicaid Services (CMS) announced that beginning January 5, 2019, they will use the new 2015 CDC Life…
CMS releases new WCMSA Reference Guide and NGHP Section 111 User Guide
The Centers for Medicare and Medicaid Services (CMS) has updated both its Workers' Compensation Medicare Set-Aside (WCMSA) Reference Guide and its Non-Group Health Plan…
Drug formularies continue to expand in workers’ comp systems
Balancing rising medical and pharmaceutical costs with appropriate and timely treatment for injured workers has been an ongoing struggle for workers’ compensation…
Workers’ Compensation Medicare Set Aside Legislation Filed, Referred to Committee
On June 18, 2018, Senators Rob Portman (R-OH) and Bill Nelson (D-FL) introduced legislation aimed at reforming the Centers for Medicare and Medicaid Services’ (CMS)…
Arizona tweaks its "full & final" workers' comp settlement law - New law provides opportunities to settle workers' comp claims
Arizona Senate Bill 1100 provides unprecedented opportunities to settle workers' compensation claims in the state.