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The Medivest Blog

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22/Jan/2025

On January 17, 2025, CMS updated its Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide to reflect a new policy in Section 4.2 to no longer review zero-dollar WCMSAs as of July 2025. Other announced changes in the WCMS Reference Guide, now in version 4.2, include an update of WCRC Review Considerations in Section 9.4.3 and corrected example calculations for Intrathecal Pump, Spinal Cord Stimulator, and Peripheral Nerve stimulator replacements were made in Section 9.4.5.

On January 21, 2025, CMS indicated via email and its website that it will be implementing two operational changes to the WCMSA review process in the first half of 2025 as follows:

Amended Reviews: Currently, amended review requests cannot be submitted until 1 year after a WCMSA case has been approved. Effective April 7, 2025, amended review requests will be allowed at any time after a WCMSA case is approved.

Zero-Dollar Set-Asides: Effective July 17, 2025, CMS will no longer accept or review WCMSA proposals with a zero-dollar ($0) allocation. Entities should still consider the parameters available in the WCMSA Reference Guide (PDF) to determine whether a zero-dollar WCMSA allocation is appropriate and should maintain documentation to support that allocation.”

As a refresher, the WCMSA Reference Guide, in Section 4.2, which describes when a zero-dollar MSA is appropriate, used to list three conditions to determine when Medicare’s future interests in a Workers’ Compensation settlement had been protected. The Reference Guide’s updated Section 4.2 has been revised significantly, and now includes only two conditions to indicate when Medicare’s future interests are protected in a WC settlement with several examples of when the second condition is met as listed in the text below:

4.2 Indications That Medicare’s Interests Are Protected

Submitting a WCMSA proposed amount for review is never required. But WC claimants must always protect Medicare’s interests. A WCMSA is not necessary under the following conditions because when they are true, they indicate that Medicare’s interests are already protected:

a) The facts of the case demonstrate that the injured individual is only being compensated for past medical expenses (i.e., for services furnished prior to the settlement); and

b) There is no evidence that the individual is attempting to maximize the other aspects of the settlement (e.g., the lost wages and disability portions of the settlement) to Medicare’s detriment.

These conditions may be demonstrated through one of the following:

• The individual’s treating physician documents in medical records that to a reasonable degree of medical certainty the individual will no longer require any treatments or medications related to the settling WC injury or illness; or

• The workers’ compensation insurer or self-insured employer denied responsibility for benefits under the state workers’ compensation law and the insurer or self-insured employer has made no payments for medical treatment or indemnity (except for investigational purposes) prior to settlement, medical and indemnity benefits are not actively being paid, and the settlement agreement does not allocate certain amounts for specific future or past medical or pharmacy services as a condition of settlement; or

• A Court/Commission/Board of competent jurisdiction has determined, by a ruling on the merits, that the workers’ compensation insurer or self-insured employer does not owe any additional medical or indemnity benefits, medical and indemnity benefits are not actively being paid, and the settlement agreement does not allocate certain amounts for specific future medical services; or

• The workers’ compensation claim was denied by the insurer/self-insured employer within the state statutory timeframe allowed to pay without prejudice (if allowed in that state) during investigation period, benefits are not actively being paid, and the settlement agreement does not allocate certain amounts for specific future medical services.

In addition, if a settlement leaves WC carriers with responsibility for ongoing medical and prescription coverage once the settlement funds are fully spent, then a WCMSA is not necessary.

Effective July 17, 2025, CMS will no longer accept or review WCMSA proposals with a zero- dollar ($0) allocation. Entities should consider the above parameters in determining whether a zero-dollar WCMSA allocation is appropriate and maintain documentation to support that allocation.

Notes:

… If Medicare made any conditional payments for WC injury-related services furnished prior to settlement, then Medicare will recover those payments. In addition, Medicare will not pay for any WC injury-related services furnished prior to the date of the settlement for which it has not already paid.

CMS will not issue “verification letters” stating that a WCMSA is not necessary.

In instances where the above conditions are not met, CMS’ voluntary, yet recommended, WCMSA amount review process is the only process that offers both Medicare beneficiaries and Workers’ Compensation entities finality, with respect to obligations for medical care required after a settlement, judgment, award, or other payment occurs. When CMS reviews and approves a proposed WCMSA amount, CMS stands behind that amount. Without CMS’ approval, Medicare may deny related medical claims, or pursue recovery for related medical claims that Medicare paid up to the full amount of the settlement, judgment, award, or other payment.”

The second to last paragraph of Section 9.4.3 was substituted from:

“The WCRC relies on evidence-based guidelines for prescription medication and medical treatment allocations; however, these are guidelines, not rules. The final determination is also based on the claimant’s past use and future recommended treatment as supported by the medical records and by current peer-reviewed medical literature. See Appendix 4 for a list of resources the WCRC uses.”

to the following:

“The WCRC final determination relies on the claimant’s past use and future recommended treatment as supported by the medical records. Evidence-based guidelines for prescription medication and medical treatment allocations and current peer-reviewed medical literature are also reviewed; however, these are guidelines, not rules. See Appendix 4 for a list of resources the WCRC uses. Treating provider plans are given preference where the two are at odds.”

The corrected example calculations in 9.4.5 for intrathecal (IT) pump pricing should be reviewed by allocators and their price coders to make sure that WCMSA pricing for IT pumps is consistent with the corrected calculations in the updated Reference Guide.

 

Take Aways:

• The new “no review” policy for zero-dollar MSA’s seems driven in large part to spirited feedback provided to CMS from the WCMSA community. There were several CMS panel discussions with MSP Network membership at the September 2024 MSP Network educational conference in Baltimore during which many of the concerns now addressed in updated Section 4.2 of the Reference Guide concerning WC cases with no payments toward denied body parts (other than during investigation periods), determinations made by WC judges/commissions at the state level, and statutory limits on payment of future medicals by WC carriers were brought up and debated.

• The drop of the one year waiting period before submitting Amended Reviews is another step toward more fair reviews by CMS and also seems to be a result of strong advocacy by those who submit allocation reports, the attorneys, who represent those entities, and the MSP Network stakeholder community at large.

• This is encouraging as it shows that CMS does listen to feedback from the MSP stakeholder community.

 

For Additional Information

Medivest will continue to monitor changes occurring at CMS and will keep its readers up to date when such changes are announced. For questions, feel free to reach out to the Medivest representative in your area by clicking here or call us direct at 877.725.2467.

 


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17/Dec/2024

On December 16th, Centers for Medicare & Medicaid Services (CMS) announced that 2025 recovery thresholds for physical trauma liability, no-fault and Workers’ Compensation settlements, judgments, awards or other payments by CMS (Settlements) will remain at $750. The full announcement can be read here.

This threshold does not apply to ingestion, implantation or exposure Settlements. The $750 threshold will continue to apply to Workers’ Compensation and no-fault insurance settlements as long as the entities do not have ongoing responsibility for medicals.  As usual, there is no Section 111 reporting requirement for Settlements under $750, and CMS will not seek recovery for conditional payments/Medicare liens arising from below threshold Settlements.

Additional information regarding the methodology used to determine the threshold has been provided here.

For Additional Information

Medivest will continue to monitor news and updates from CMS, and will keep its readers up to date when important announcements are made. For questions about this chart or any other recent updates, feel free to reach out to the Medivest representative in your area by clicking here or call us direct at 877.725.2467.


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05/Dec/2024

On November 26th, 2024, the Centers for Medicare & Medicaid Services (CMS) shared a new report titled Workers’ Compensation Medicare Set-Aside (WCMSA) Fiscal Year Statistics 2024. The report provides five fiscal years of data regarding Workers’ Compensation Medicare Set-Aside (WCMSA) Proposed Value and Workers’ Compensation Review Contractor Values (WCRC) from 2020 to 2024.


Analysis

There was a 5.6% decrease in the number of WCMSA allocation reports that were submitted to CMS for review from 15,743 in Fiscal Year (FY) 2023 to 14,862 in FY 2024. There was also a drop in average settlement value of 4.7% from an average of $159,976.93 in FY 2023 to only $152,487.15 in FY 2024.

Despite this drop in settlement values, the WCMSA proposals for allocation reports submitted to CMS remained relatively flat, only dropping less than 2/10ths of one percent from $70,887.33 in FY 2023 to $70,775.58 in FY 2024. Counterhighers from CMS, correspondingly remained relatively flat moving from its published increase between the submitted versus recommended amount of 22% in FY 2023 to an increase of 21% in FY 2024.

The biggest change in the WCMSA CMS review statistics in recent years is that in 2022, when Section 4.3 was first added to the Reference Guide, the average counterhigher jumped from a 13-15% increase for FY 2020-2022 to what may be a “new era” for the last two years being between a 21-22% increase. Taking the average of 14% from FY 2020 – FY 2022 to the average of a 21.5% counterhigher increase for FY 2023 – FY 2024, this amounts to 31% increase in the counterhigher percentages!

Proposed MSAs and Total Settlement Amounts

Pre-CMS review WCMSAs constituted around 46% of the total settlement amount in FY 2024 up from 44% in FY 2023.

Medical vs Rx

Medical items and services represented approximately 79.3 % of the approved MSA amounts, whereas Rx represented 20.7% of the approved WCMSA amounts in FY 2024. The medical portion was 76.9% in FY 2023 with Rx accounting for 23.04% of the MSA in FY 2023. In FY 2020 by contrast, the medical portion was 68.6% and Rx expenses represented 31.4% of approved WCMSA amounts. Rx expenses have declined by 34% since FY 2020 as a percentage of the WCMSA . While several factors are likely to be at play here, CMS’ use of sometimes aggressive NDCs to price drugs may be one culprit. Medivest consistently sees submitted MSAs priced using drug NDCs unavailable in the actual market, and well below market average.

Take Aways

While reviews by CMS could in theory include acceptances or even reductions in the amount proposed by submitters as counterlowers, those who submit WCMSA’s have come to know that CMS reviews of WCMSA’s most often come back in the form of a counterhigher. It is important to distinguish a counterhigher from the term counter offer used in contract negotiations. While the WCMSA submission process is entirely voluntary, CMS’s Workers’ Compensation Medicare Set-Aside Arrangement Reference Guide (WCMSA Reference Guide) language and CMS operations consider the CMS review/approval response to be CMS’ final position on the acceptable amount to be set aside to protect Medicare’s future interests in the settlement, unless there is a successful Re-Review (allowed only for instances where there is a math error or the discovery of a document in existence prior to the time of submission but not included in the submission which is then allowed to be provided for the once only Re-Review opportunity). As a result, many in the industry say CMS uses the counterhigher to “voluntell” the parties the amount required to be set aside from their settlement for their WCMSA amount and that if an alternate amount is set aside or no amount is set aside, injury related medicals otherwise covered by Medicare could be denied by Medicare up to the settlement amount minus procurement costs instead of up to the CMS approval amount.

As background, total WCMSA submissions to CMS declined steadily between CMS’ FY 2020 and FY 2022, descending from 16,517 to 13,752, a reduction of almost 17% in three years. FY 2023’s 15,743 submission count seemed to have been a reversal of that trend until the 14,862 number for FY 2024 was reported. This seems to be the market shaking out the initial scare from Section 4.3. in which CMS had for the first time discussed “non-submit” or “evidence-based” MSA allocation reports as potential attempts to shift the burden of payment for injury related Medicare covered medicals to Medicare.

Proposed vs Recommended

While one can understand that CMS wants to protect the Medicare Trust Funds for both Medicare Part A and Part B, it does not seem to be productive for CMS to unfairly punish those who decide to voluntarily submit MSA’s in accordance with CMS WCMSA Reference Guide methodology. The statistics described above show that while the settlements have come down recently, the amount of the submitted WCMSA’s have not, so it’s not as if submitters have been lowballing their submissions. Those carriers who embraced a non-submit program in recent years to avoid higher WCMSA amounts associated with large counterhighers from CMS, may have not yet seen enough consequences to encourage a large return to voluntary submission practices.

The Big Question

These are statistics from those WCMSA’s submitted for approval, meaning they were written by industry-trained professionals in an attempt to match CMS’ recommended methodology. If the industry for those who submit have been consistent, but there has still been an increase in the counterhigher percentages, what has changed at CMS? While the fear in the stakeholder industry used to be focused on financial recovery by CMS under the Medicare Secondary Payer Act (MSP), could it be that CMS’s position concerning non-submitted WCMSA’s is evolving in the form of future Medicare denials for injured claimants who will be left to their own devices to attempt administrative appeals over those denials? The discussions of Section 4.3 of the WCMSA Reference Guide may have just the start of the new era, while CMS continues to build out its computer system in the background. Now, we are aware that there are new Section 111 Reporting requirements include the reporting of WCMSA amounts for all TPOC settlements involving current Medicare beneficiaries whether the WCMSA was submitted to CMS for review or not. Furthermore, the new Civil Monetary Penalty enforcement for untimely Section 111 reporting of ORM and TPOC applicable as of October of this year to be audited in October of 2025 seem to be clear additional steps of the new era, with additional data for CMS to continue to expand Medicare medical and Rx denials in the future. Routine reviews of business practices are prudent in any industry and as we head into another fiscal year, it is a great time to review your business practices to confirm your firm or company is taking the steps to help ensure best in class compliance standards that align with your clients’ interests and risk tolerances.

For Additional Information

Medivest will continue to monitor changes occurring at CMS and will keep its readers up to date when such changes are announced. For questions, feel free to reach out to the Medivest representative in your area by clicking here or calling us directly at 877.725.2467.

 


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26/Sep/2024

Mandatory Reporting for Liability Insurance (including Self-Insurance), No-Fault Insurance and Workers’ Compensation

CMS will be hosting a webinar regarding Certain Civil Money Penalties for NGHP Responsible Reporting Entities (RREs). The format will be opening remarks and a presentation by CMS that will include reminders about the Final Rule, the auditing process and important dates, followed by a question and answer session. RREs who would like to submit questions in advance of the webinar are encouraged to do so using the dedicated resource mailbox at Sec111CMP@cms.hhs.gov.


 

Date: October 17, 2024
Time: 1:00 PM ET

Webinar Link: https://cms.zoomgov.com/j/1602011678?pwd=e54vgVqZczEGeWbDf4hk95AeozMh47.1
Passcode: 145914

Or to connect via phone:

Conference Dial In: (833) 568-8864
Conference Passcode: 160 201 1678

Important Note: This is a public webinar and there is no pre-registration needed. The webinar link should only be utilized the day of the webinar. Due to the number of expected participants, please log in at least 10 minutes prior to the start of the presentation.


 

Additional information about the most recent updates from CMS can be found here. If you have questions on how topics discussed in this webinar may affect your clients or your company, please contact Medivest or call us at 877.725.2467.


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28/Aug/2024

Mandatory Reporting for Liability Insurance (including Self-Insurance), No-Fault Insurance and Workers’ Compensation

CMS will be hosting a Section 111 NGHP Reporting webinar. The format will be opening remarks by CMS, a presentation that will include NGHP reporting best practices and reminders, followed by a question and answer session. For questions regarding Section 111 reporting, prior to the webinar, please utilize the Section 111 Resource Mailbox PL110-173SEC111-comments@cms.hhs.gov.

 


 

Date: Thursday September 12, 2024
Time: 1:00 PM ET

Webinar Link: https://cms.zoomgov.com/j/1619262037?pwd=VnY1RWFLTWc4RXN4RjZ5YzV4WDQvdz09

Passcode: 315331

  Or to connect via phone:

Webinar Dial In: 1-833-435-1820
Webinar ID: 161 926 2037


 

Additional information about the most recent updates from CMS can be found here. If you have questions on how topics discussed in this webinar may affect your clients or your company, please contact Medivest or call us at 877.725.2467.

 


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26/Aug/2024

It’s been a busy 2024 for CMS. Since February 2024, over half a dozen updates have been made to Section 111 Mandatory Insurance Reporting and CMS’s policies.  

Ultimately, these new changes increase awareness and focus on post-settlement MSA spending, emphasizing the importance of utilizing a competent professional administrator 

What this means is you need Medivest’s Asure Pro-Admin more than ever to navigate these changes and keep all settlement parties from getting penalized for non-compliance!  

Medivest’s Asure Pro-Admin Helps Protect All Parties 

 

Asure Pro-Admin:
Professional Administration for MSA Accounts by the professionals
 

  • Medivest claimant accounts saved over 70% of what they were billed by providers over the last 12 months
  • An average of 23.3% of the original MSA is disbursed to the surviving beneficiary or reversionary interest party upon the claimant’s death
  • During our 27 years of business, we have only had a 2% member cancellation rate due to unforeseen reasons other than death. This remarkable retention rate underscores the value and satisfaction our members experience with our services
  • Medivest members and clients can be confident that a Claims specialist will review every line item on every bill submitted, ensuring proper coordination of benefits

 

Self-Asure:
The DIY solution with Medivest’s expert support

  • Don’t go it alone! Use Self-Asure to navigate the CMS government maze 
  • The Self-Asure Self-Administration Kit, an innovative tool first created by Medivest, is good for injured parties with a small MSA that is designed to exhaust in a short length of time. Self-Asure provides guidance to individuals who opt to manage their own MSA, and pairs it with phone support and medical bill review from Medivest’s experienced Member Services team.  
  • However, a Self-Administration Kit still has limitations, particularly if multiple bills come in at once. So the settlement parties need to carefully consider Medivest for professional administration per CMS’s recommendation. 

 

4 Asure:
Easy approach to navigate settlement compliance for Insurer, Self-insured, and TPA without adding ANY work to the adjuster’s already full plate. The streamline process of:

  • Medicare Status check/lien investigation to determine if MSA is recommended
  • Structured Settlement consultant for rated age and MSA funding 
  • MSA Allocation Report (if needed) 
  • Professional Administration of MSA 

CONTACT MEDIVEST TODAY – WE ARE HERE TO HELP!

877-725-2467 (Monday – Friday 8am to 5pm EST)

 

Summary/Takeaways 

MMSEA Section 111 Mandatory Insurer Reporting (NGHP)

Medicare is ramping up its data collection. New fields have been added to the Section 111 Claim Input File to capture WCMSA information on all Workers’ Compensation (WC) claims involving Medicare beneficiaries.  

These data collections will have a significant impact on reporting and WCMSA compliance for the use of non-submit and Evidence Based Medicare Set-Aside arrangements. By capturing this new data, Medicare will know when funds have exhausted, make more appropriate determinations regarding the coordination of benefits, and more thoroughly investigate which injury related medical payments they should be denying. The new fields will become effective 4/4/25. 

Self-Administration Toolkit, Version 1.6 

Under the WCMSA Guidelines, CMS has the right to recovery. Over 1/3 of Medicare recipients have a Medicare Advantage Plan (MAP). These plan providers have asked for the same recovery rights that CMS has. The last sentence in Section 4.1.3 of the new Self-Administration Toolkit takes the first steps to clearly spell out that CMS is extending their rights of recovery to MAP partners: 

If you are enrolled in a Medicare Advantage or prescription drug plan, please contact your plan to discuss your WCMSA, if you have not already done so.  

WCMSA Reference Guide, Version 4.3 

In the latest update of the WCMSA reference guide, Medicare Advantage Plans continue to be spotlighted. In Section 4.1.3, CMS states: 

CMS notifies Part C and D plan sponsors that a WCMSA has been approved and instructs plan sponsors to conduct Medicare Secondary Payer (MSP) investigations. However, CMS does not relay WCMSA details to plan sponsors… The administrator must provide details concerning treatments and medications used exclusively to treat a related illness or injury to the plan sponsor so the sponsor may avoid making primary payment in the future.

CMS instructs the MAP sponsors that a WCMSA exists but doesn’t share any specific details of the MSA. It seems inevitable that this will create a communication breakdown at some point. The onus of communication is put entirely on the administrator. For a professional administrator, this will be a common (and new) task, but for someone attempting to self-administer their WCMSA, a whole new world of responsibility and questions are about to be spotlighted.

For the full information on these alerts from CMS, please visit the “What’s New” page of their website. 

For Additional Information

Medivest will continue to monitor changes occurring at CMS and will keep its readers up to date when such changes are announced. For questions, feel free to reach out to the Medivest representative in your area by clicking here or call us direct at 877.725.2467 (Monday – Friday 8am to 5pm EST).

 


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22/Jul/2024

On July 22, 2024 the Centers for Medicare & Medicaid Services (CMS) released their data for the Top 10 Section 111 Non-Group Health Plan Reporting Errors January – June 2024. The chart with the list of errors and their rank can be viewed below. A downloadable PDF of this chart along with an explanation of the error codes can be viewed here at the CMS website.

Medivest will continue to monitor news and updates from CMS, and will keep its readers up to date when important announcements are made. For questions about this chart or any other recent updates, feel free to reach out to the Medivest representative in your area by clicking here or call us direct at 877.725.2467.


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15/Jul/2024

Independent Audit Verifies Medivest’s Internal Controls and Processes

Oviedo, FL – Medivest Benefit Advisors LLC, a leader in Medicare Secondary Payer (MSP) services and settlement planning, today announced that it has completed its SOC 2 Type II audit, performed by KirkpatrickPrice. This attestation provides evidence that Medivest has a strong commitment to security and to delivering high-quality services to its clients by demonstrating that they have the necessary internal controls and processes in place.

A SOC 2 audit provides an independent, third-party validation that a service organization’s information security practices meet industry standards stipulated by the AICPA. During the audit, a service organization’s non-financial reporting controls as they relate to security, availability, processing integrity, confidentiality, and privacy of a system are tested. The SOC 2 report delivered by KirkpatrickPrice verifies the suitability of the design and operating effectiveness of Medivest’s controls to meet the standards for these criteria.

“The SOC 2 audit is based on the Trust Services Criteria,” said Joseph Kirkpatrick, President of KirkpatrickPrice. “Medivest delivers trust-based services to their clients, and by communicating the results of this audit, their clients can be assured of their reliance on Medivest’s controls.”

About KirkpatrickPrice:

KirkpatrickPrice is the leader in cyber security and compliance audit reports. Our experienced auditors know audits are hard, so they take complicated audits such as SOC 1, SOC 2, PCI DSS, HIPAA, HITRUST, GDPR, and ISO 27001 and make them worth it. The firm has issued over 10,000 reports to over 1,200 clients worldwide, giving its clients trusted results and the assurance they deserve. Using its Online Audit Manager, the world’s first compliance platform, KirkpatrickPrice partners its clients with an expert to guide them through the entire audit process, from audit readiness to final report.  For more information, visit www.kirkpatrickprice.com, follow KirkpatrickPrice on LinkedIn, or subscribe to their YouTube channel.


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09/Apr/2024

On April 1, 2024, Centers for Medicare & Medicaid Services (CMS) updated the MMSEA Section 111 Non-Group Health Plan (NGHP) User Guide version 7.5. It has been posted to the NGHP User Guide page on CMS.gov.  The NGHP User Guide version 7.5 replaces Version 7.4 which was released on January, 30, 2024.

To download the updated MMSEA Section 111 NGHP User Guide 7.5 click here.

MMSEA III- April 1, 2024 – NGHP User Guide Downloads 7.5

Updates:  There are no changes for this version

Updates:  There are no changes for this version.

Updates:   The submission of information related to Workers’ Compensation Medicare Set-Aside Arrangements (WCMSAs) will be required for all records submitted with a TPOC date after April 4, 2025 (Section 6.5.1.1). As of January 1, 2024, the threshold for physical trauma-based liability insurance settlements will remain at $750. CMS will maintain the $750 threshold for no-fault insurance and workers’ compensation settlements, where the no-fault insurer or workers’ compensation entity does not otherwise have ongoing responsibility for medicals (Section 6.4).

Updates:  The submission of information related to Workers’ Compensation Medicare Set-Aside Arrangements (WCMSAs) will be required for all records submitted with a TPOC date after April 4, 2025 (Sections 6.1, 6.4.4, and 6.5). As of January 1, 2024, the threshold for physical trauma-based liability insurance settlements will remain at $750. CMS will maintain the $750 threshold for no-fault insurance and workers’ compensation settlements, where the no-fault insurer or workers’ compensation entity does not otherwise have ongoing responsibility for medicals (Section 6.4).

Updates:  Beginning April 4, 2025, CMS will collect information about WCMSAs through Section 111 reporting. To support this effort, related fields have been added to the Claim Input File Detail Record; note that as the current file layout is unchanged, all the not-yet-implemented codes are marked with an asterisk (*) in the field number to distinguish them from the those in the current file layout. Once they are in effect, all the asterisks will be removed and the fields that follow them will be renumbered. Error codes related to these fields have also been added to the Claim Response File Error Code Resolution Table (Appendix A and Appendix G).

Updates:  The end-of-line character has been clarified for files using HEW software (270/271 File Translation).

For Additional Information

Medivest will continue to monitor changes occurring at CMS and will keep its readers up to date when such changes are announced. For questions, feel free to reach out to the Medivest representative in your area by clicking here or call us direct at 877.725.2467.

 


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25/Mar/2024

On Tuesday April 16, 2024, Centers for Medicare & Medicaid Services (CMS) will be hosting a second webinar regarding the expansion of Section 111 Non-Group Health Plan (NGHP) Total Payment Obligation to Claimant (TPOC) reporting to include Workers’ Compensation Medicare Set-Aside (WCMSA) information. After the first webinar in November, CMS received additional questions and feedback from the industry. The intent of this webinar is to ensure that RREs will be prepared for the change once implemented.

With that in mind, this webinar will include a background recap, summary of technical details, updated timelines and CMP impacts. The presentation will be followed by a question and answer session. Because this expansion impacts reporting of WCMSAs, it is strongly recommended that Responsible Reporting Entities (RREs) that report Workers’ Compensation settlements attend.


 

Date:  April 16, 2024
Time:  2:00 PM EST

Webinar Link: https://cms.zoomgov.com/s/1610015349?pwd=NHcza3NhcDlCdjM0cVhENWlNcFBjZz09
Passcode:  750766

Or to connect via phone:

Conference Dial In:  1-833-568-8864
Conference Passcode:  161 001 5349


 

Additional information about the most recent updates from CMS can be found here. If you have questions on how topics discussed in this webinar may affect your clients or your company, please contact Medivest or call us at 877.725.2467.

 


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