On Friday, February 23, 2024, Centers for Medicare & Medicaid Services (CMS) published an alert regarding the upcoming change to Section 111 reporting to include Workers’ Compensation Medicare Set-Aside (WCMSA) amounts for Workers’ Compensation settlements meeting the $750 threshold regardless of whether the WCMSA was submitted to CMS for approval or not.
“All MSA funding for WC settlements shall be reported regardless of whether or not an approval was previously sought from the CMS. This change will be prospective for the Total Payment Obligation to Claimant (TPOC)s on or after the implementation date. For example, records submitted on a production file with a TPOC date on or after April 4, 2025, will be subject to the new edits.”
Please note that testing of the new fields will be available as early as October 7, 2024. The full alert is available at in the Download section of the NGHP Alerts page here.
For Additional Information
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