On July 31, 2017, CMS published Version 2.6 of the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide. The latest version of the Guide includes the following changes:
- Further clarified expectations of Hearings on the Merits (Section 4.1.4);
- Clarified jurisdictional verification (Section 9.4.4, Step 5)
- Updated defined requirements for Spinal Cord Stimulator pricing (Section 9.4.5); • Expanded state-specific statute guidelines (Section 9.4.5);
- Updated Off Label Medication requirements (Section 188.8.131.52)
- Clarified total settlement calculations guidelines (Section 10.5.3); • Updated Re-review policy (Section 16.0) • Added required resubmission requirements (Section 16.1) • Updated administration recommendations (Section 17.1) • Added MyMedicare.gov link (Section 17.6)
- Clarified change of submitter requirements (Section 19.4)
Click below for a side by side comparative analysis of the changes made from Version 2.5 to Version 2.6 of the Workers Compensation Medicare Set Aside Reference Guide.