Workers' Compensation Medicare Set-Aside (WCMSA)

2/25/2019 - 1 min read

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 number on all ongoing letters.

1/7/2019 - 4 min read

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.

12/13/2018 - 1 min read

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 Table to calculate adjusted life expectancies in Workers’ Compensation Medicare Set-Asides (WCMSAs).

10/5/2018 - 2 min read

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 (NGHP) Section 111 User Guide.

8/14/2018 - 6 min read

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 professionals. But recent trends indicate a positive change for the industry.

6/29/2018 - 2 min read

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) Workers’ Compensation Medicare Set-Aside (WCMSA) process.

5/22/2018 - 5 min read

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.

5/9/2018 - 6 min read

Five steps to reduce your WCMSA costs

It is no secret that high Workers’ Compensation Medicare Set Aside (WCMSA) allocation amounts can complicate claim settlement.

4/18/2018 - 3 min read

New Kentucky workers’ compensation law limits treatment to 780 weeks for certain claims

On March 30, 2018, Kentucky House Bill (HB-2) was signed into law which makes major changes to the Kentucky workers’ compensation statute.

4/12/2018 - 2 min read

CMS issues new regulations aimed at identifying and limiting potential opioid abuse

On April 2, 2018, C,S issued a final rule which updated regulations for Medicare Advantage Plans (MAP) and Medicare Part D programs.

3/23/2018 - 1 min read

CMS releases WCMSA reference guide (Version 2.7)

The Centers for Medicare and Medicaid Services (CMS) has released its latest WCMSA Reference Guide (Version 2.7).

3/8/2018 - 3 min read

WCMSA update: CMS holds WCRC transition webinar

On March 7, 2018, CMS held a transition webinar regarding its upcoming Workers’ Compensation Review Contractor (WCRC) transition.

3/2/2018 - 1 min read

WCMSA update: New WCRC takes over March 19th – webinar set for March 7th

CMS has announced that its new Workers Compensation Review Contractor, Capitol Bridge, LLC will assume WCRC responsibilities on March 19, 2018. CMS is holding a transition webinar on March 7, 2018 at 1:00 p.m. EST to address this new change.

2/28/2018 - 7 min read

Medicare watch list: Staying ahead of the Medicare Secondary Payer compliance curve

As another new year settles in, we know at least one thing is certain: MSP compliance will continue to present formidable challenges for claims payers.

12/19/2017 - 2 min read

CMS and opioid medications - Will CMS address opioids in 2018?

Currently, CMS takes a strict formulaic approach that will price all Medicare covered medication related to a claim at the present dosage and frequency for the “duration of a claimant’s life expectancy” and regardless of whether or not the claimant is a Medicare beneficiary or has Medicare Part D coverage.