Our Insights

In the dynamic world of governmental oversight, managing risks and reducing errors are crucial for ensuring compliance. Recently, these risks have become more pronounced in the Medicare Secondary Payer arena due to increased governmental scrutiny and new legal enforcement measures. Even minor typographical errors can lead to penalties and other significant liabilities. Our most recent […]

A message from Allan Koba Principal, Ciara Koba   Growing up, my oldest sister was the kind of environmentalist who made you side-eye her choices (lovingly, of course). Case in point: When she visited me in Pittsburgh years ago, she met with an engineer that built her a car that ran on used cooking oil […]

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 […]

As of April 2025, the new Section 111 reporting requirements mandate the inclusion of MSA data for all workers’ compensation settlements, regardless of whether the voluntary MSA review process with CMS was followed. CMS has indicated that the reported data would be posted with a “W” to each applicable beneficiary’s Common Working File (CWF), thereby […]

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 […]