Learning about MSAs

WCMSA Helpful Hints – Part 10 of 10

Submitting a Workers’ Compensation Medicare Set-Aside Allocation (WCMSA) is simpler in theory than in practice. Below is a common error often made when submitting a WCMSA to the Centers for Medicare & Medicaid Services (CMS), as well as some helpful hints to avoid the error. If you need more information or further help with settling claims or setting up a Medicare Set-Aside for a client, call 855.931.3003 or fill out the form.




Helpful Hint*

  • Please review Sections 9.4.6.1 & 9.4.6.2 of the WCMSA Reference Guide for information on
    prescription drug pricing.


Helpful Hint*

  • Please be sure to specify each date of injury being settled, all body parts/conditions associated with each date of injury, including body parts that are accepted or denied by the carrier, and whether any of the body parts/conditions are left open for medicals by the carrier.
  • We need a pay record for each date of injury or documentation that the payment record provided includes/reflects each date of injury.
  • We need two years of medical records that reflect treatment for each body part being settled, dated within six months of the date of submission or reopen date.
  • We need prescription records that reflect all prescription medication for each industrial
    condition, including dose and frequency.


Don’t take unnecessary risks during settlement! Protect your clients’ Medicare benefits with a MSA.  To get started or even if you just have questions about a particular case you’re working on, contact Medivest at 855.931.3003 or fill out the form.


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