Author Archives: Jules Mandell

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The New WCMSA Reference Guide Version 3.5 “Clarification” Regarding Evidence-Based MSAs

by B. Smith The Centers for Medicare and Medicaid Services (“CMS”) issued an updated Workers’ Compensation Medicare Set-Aside Arrangement (“WCMSA”) Reference Guide (the “Guide”), Version 3.5, dated January 10, 2022. As noted by CMS, changes to the Guide includes “clarification” regarding “non-CMS-approved products to address future medical care” which can be found in Section 4.3. […]

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New Section 111 TPOC Alert Issued by CMS

by B. Smith CMS issued a new alert regarding the requirement to complete the Funding Delayed Beyond TPOC Start Date field in applicable situations. Specifically, the alert is a reminder that if funding is delayed after the settlement date and the TPOC Date in Field 80 has been reported, Responsible Reporting Entities  (RREs) should also […]

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CMS Issues New Alert Regarding Incorrect Reporting of No-Fault Policy Limits

By B. Smith On October 26, 2021, CMS issued an alert addressing the importance of accurately reporting no-fault policy limits as part of Section 111 Reporting. CMS acknowledged that policy limits may vary based upon state law or contract terms. In these situations, CMS notes that the reported policy limit “should reflect the actual amount […]