Our Insights

The Centers for Medicare & Medicaid Services (CMS) has continued to refine its guidance on Workers’ Compensation Medicare Set-Aside Arrangements (WCMSAs) with the release of Version 4.5 of the WCMSA Reference Guide. Simultaneously, CMS conducted an important webinar clarifying the integration of WCMSA reporting requirements within the existing Section 111 Mandatory Insurer Reporting (MIR) framework […]

🚨 The Case of the Unnecessary Transplant Picture this: A middle-aged woman with post-COVID cardiac complications. A shocking recommendation for a heart transplant buried in her records. A price tag of millions added to her Medicare Set-Aside (MSA). But here’s the twist: the suggestion came from an internist, not a cardiologist—and it was about to […]

Already off to a hot year in WCMSA updates, CMS kicks off Q2 with another round of new information for the Medicare Secondary Payer community. Workers’ Compensation Medicare Set-Aside Reference Guide Version 4.3 published April 7, 2025 serves up the awaited language associated with the Amended Review timeframe elimination, as well as a Change of […]

All the talk these days of CMS eliminating waiting periods for Amended Review of an MSA has cast a shadow on its predecessor – the Re-Review process. If you get a result from CMS and don’t want to bite the one-time Amended Review apple just yet, Re-Review is alive and well and yielding results. This […]

The Zero Dollar Medicare Set-Aside: A Budget-Friendly Mystery Let’s talk about a little-known gem in the world of Medicare set-asides: the infamous zero dollar set-aside. Now, you might be wondering, “What in the world is a zero dollar Medicare set-aside?” A zero dollar set-aside is when it is determined that, after careful analysis, you don’t […]

Attention all workers’ compensation carriers! Are you ready to revolutionize how you handle Medicare set-asides in nuisance value cases? Say goodbye to the old, cumbersome processes and hello to our innovative MSA111 product, designed specifically to help you plug the gaps and streamline your compliance efforts. 🌟 Why MSA111?  If you’re settling cases with a Medicare beneficiary and […]