CMS Releases Updated WCMSA Reference Guide v4.0

On April 1, 2024, The Centers for Medicare and Medicaid Services (CMS) announced an update to the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide. This update represents Version 4.0, and replaces Version 3.9 that was released in May of 2023.

The updates noted in this reference guide are as follows:

·      Sections 11.1.1 and 17.5 were updated with a statement specific to beneficiaries encouraging them to use the Medicare.gov portal as the most efficient method of submitting annual attestations.

·      Section 10.3 was updated with a link to the latest CDC Life Tables

You can view WCMSA Reference Guide v4.0 by clicking this link.

CMS Releases Updated WCMSA Reference Guide

On May 15, 2023, The Centers for Medicare and Medicaid Services (CMS) released an updated Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide. This latest update is version 3.9, which replaces version 3.8 which was released in November of 2022. You can view the WCMSA Reference Guide v3.9 by clicking here.

Changes include the following:

• Appendix 5 has been updated to indicate that all workers’ compensation letters currently signed with CMS’ Director of Financial Service Group name and signature image have been updated to reflect the current CMS customer service contact information.

• The CMS Regional Offices are no longer responsible for approving initial determinations.

• Clarification has been provided regarding intrathecal pump, spinal cord stimulator, and peripheral nerve stimulator replacement frequency calculation.

• The maximum time limit for eligibility has been removed from the Amended Review process.

• The 94585 ZIP Code has been added to the Walnut Creek Medical Center in the table listing major medical centers.

• The CDC Life Tables link was updated.