CMS Updates WCMSA Reference Guide: New Policy on EBMSAs

Yesterday, CMS released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide.  Version 3.5 of the guide contains two new sections and no other changes.  The additional sections relate to evidence-based on non-submit Medicare Set-Asides and the pre-requisite steps prior to submitting a workers’ compensation settlement for review. ECS has evaluated the additional sections and… Read more »

CMS Section 111 User Guide Update Includes Key Policy Announcement

On Monday December 20th, the Centers for Medicare & Medicaid Services (CMS) released an updated Section 111 Non-Group Health Plan User Guide, clarifying two recent alerts.  The new User Guide adjusts guidance for reporting settlements by clarifying when reported settlement information may be considered late and expanding the circumstances where the “Funding Delayed Beyond TPOC… Read more »

On CMS’ Recent Section 111 Alerts

Late last month we wrote about a Centers for Medicare & Medicaid Services (CMS) Section 111 reporting alert regarding updates to the “No-Fault Policy Limits” field.  Then, late last week, CMS released another alert.  This alert – entitled “Alert: Use of the Funding Delayed Beyond TPOC Start Date Field” – goes into some detail about… Read more »

PAID Act Becomes Law

This week Medicare updated the announcement to better define the scope of the proposal.

COMP Act Introduced in U.S. House

It is that time of year when we alert you to a Workers’ Compensation Medicare Set-Aside bill in Congress. Rep. Mike Thompson (D-CA) introduced H.R. 4161 on August 2nd. The bill’s co-sponsor is Rep. George Holding (R-NC). Recall Rep. Thompson co-sponsored this same piece of legislation last year, only renaming the bill as the “Coordination of Medicare Payments… Read more »

CMS Issues Final Rule Implementing Appeal Provisions of the SMART Act

On Friday, February 27, the Centers for Medicare and Medicaid Services published its final rule implementing provisions of the Strengthening Medicare and Repaying Taxpayers (SMART) Act of 2012 regarding the appeals process for liability insurance (including self-insurance), no-fault insurance, and workers’ compensation laws or plans when Medicare pursues a Medicare Secondary Payer (MSP) recovery claim… Read more »