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ARTICLE · 18 JANUARY 2022

New CMS Policy Targets "Evidence-Based" Or "Non-Submit" MSAs

Teague Campbell Dennis & Gorham
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The newest version of the "Workers' Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide" contains just one change, but this one change was apparently intended to send a strong message

United StatesFinance and Banking
Daniel W. Hayes
Daniel W. Hayes

The newest version of the "Workers' Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide" contains just one change, but this one change was apparently intended to send a strong message to WCMSA industry.

According to the new reference guide dated January 10, 2022, CMS is concerned that products commonly called "evidence-based" or "non-submit" MSAs are not adequately protecting Medicare's interests. As noted by CMS, many of these MSA products intend to indemnify insurance carriers and Medicare beneficiaries against future conditional payments made by CMS. This type of product would presumably protect the parties to a settlement against any attempt by CMS to seek reimbursement on the basis an MSA was "underfunded." Here is the full text:

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