CMS recently announced an upcoming webinar on March 25, 2026 at 1:00pm (EST) to review the Workers’ Compensation Medicare Set-Aside (“WCMSA”) reporting process. The CMS webinar will cover issues encountered from CMS’ perspective and review WCMSA reporting best practices.
What is WCMSA reporting?
ECS has extensively covered WCMSA reporting previously. To summarize, effective April 4, 2025, all responsible reporting entities (RREs) are required to report WCMSA information on claims with reportable TPOC to give CMS information on whether a MSA was incorporated into the settlement.
Is this only for workers’ compensation claims?
Yes, this reporting obligation does not apply to liability or no-fault claims.
Have there been any issues with the new WCMSA reporting?
Yes! Notably, there have been significant issues caused with the CMS submission process and CMS approval of WCMSA submissions. These issues have included:
CMS refusing to accept submission of a WCMSA if Section 111 reporting has a TPOC entry.
CMS ending the WCMSA submission process in progress if a TPOC/WCMSA entry is made after the MSA is submitted to CMS, but before CMS approval.
CMS has rescinded prior MSA approvals if the reported WCMSA information does not match the amount CMS approved by the WCMSA submission process.
CMS has converted professionally administrated MSAs into self-administered MSAs if professional administration (an optional reporting field) is not reported.
Needless to say, this has caused quite a headache for insurers, TPAs and injured workers who just want to get CMS approval of their MSA to proceed with settlement. There has been no public statement made by CMS to-date. Settling parties effectively have to decide if they are going to wait on CMS to provide a path forward on getting the MSA process or decision back on track or to settle without CMS approval. Given these issues have been ongoing for over six months, impacted parties and the industry as a whole have eagerly awaited CMS to address these matters publicly. It seems like that time is March 25, 2026.
ECS Can Help Assist with Your Section 111 Reporting Needs
ECS and our expert Section 111 team are available to assist you with your reporting needs. We will continue to keep readers apprised of further agency developments from CMS as we monitor this and all areas of MSP compliance closely. ECS Section 111 reporting clients should address any questions to their assigned MMSEA Compliance Manager or via email at MIRService.Support@examworkscompliance.com. Should you have any questions on these developments please contact Michael Flower at Michael.Flower@ExamWorksCompliance.com.