Workers' Compensation Medicare Set-Aside (WCMSA)

3/5/2021 - 1 min read

Starting March 27, 2021, CMS will use the 2018 CDC Life Table for WCMSAs

Starting 3/27/21, CMS has announced that it will use the new 2018 CDC Life Table to calculate adjusted life expectancies in Workers’ Compensation Medicare Set-Asides (WCMSAs).

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.

5/15/2020 - 1 min read

CMS releases new WCMSA reference guide (Version 3.1)

The Centers for Medicare and Medicaid Services (CMS) has just released its latest version of the WCMSA reference guide version 3.1 (May 11, 2020).

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.

Glenn Carstens Peters Npxxwgq33zq Unsplash 1

3/30/2020 - 4 min read

Social Security Administration suspends processing of third-party requests to determine SSDI status

As of 3/17/20, all the Social Security Administration field offices have been closed to the public in response to the growing COVID-19 pandemic according to its website. Despite the closures, the SSA remains functional.

National Cancer Institute Nfvdkihxylu Unsplash 1

3/23/2020 - 1 min read

Starting April 25, 2020, CMS will use the 2017 CDC life table for WCMSAs

In an alert dated 3/17/20, CMS announced beginning 4/25/20, it will use the new 2017 CDC life table to calculate adjusted life expectancies in Workers’ Compensation Medicare Set-Asides.

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.

10/10/2019 - 3 min read

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).

9/17/2019 - 1 min read

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.

8/1/2019 - 3 min read

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

5/28/2019 - 3 min read

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 to workers’ compensation.