Tag Archives: CMS

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New WCMSA Reference Guide

CMS has issued an updated Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide, Version 3.4. The Guide has several minor changes including CMS’s focus on the receipt of appropriate settlement documents for the approval of the WCMSA.  Specifically, in Section 10.5 and in various sample letters in Appendix 5, CMS notes that “approval of the […]

Section 111 PAID Act Updates

On September 9, 2021, CMS hosted another webinar to discuss upcoming changes to the Section 111 query process.  These changes are being made to comply with the provisions of the PAID Act which requires CMS to provide enrollment information for Medicare Part C and Part D plans.  The following are some of the key highlights […]

CMS to Host PAID Act Webinar

On September 9, 2021,  CMS will be hosting a Provide Accurate Information Directly (PAID) Act testing webinar.  Webinar details can be found here. Should you have any questions regarding the PAID Act and the impact it will have on the Section 111 query process, please contact the NuQuest Settlement Consultants at: [email protected]  

CMS Releases PAID Act Presentation

The presentation from the June 23, 2021 PAID Act Webinar is now available in the download section of the NGHP What’s New page.  A link to the presentation can be found here.   Please see our prior blog by clicking here with a summary of the presentation highlights.  If you have any question regarding Section 111 […]

CMS Issues New Section 111 NGHP User Guide and PAID Act Technical Alert

CMS has been very busy this month.  In addition to the webinar scheduled for June 23, 2021 to discuss the Provide Accurate Information Directly (PAID) Act.  CMS has now issued a new NGHP User Guide and a PAID Act technical Alert.  The User Guide and the Alert contain significant substantive and technical changes regarding ORM […]

CMS Releases Updated WCMSA Reference Guide 3.3

CMS has released a new version of the Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide, 3.3, COBR-Q2-2021-v3.3 dated April 19, 2021. The new Guide includes additional language regarding the calculation of the seed money for structured settlements. When a structured WCMSA is utilized by the parties, in addition to annual payments, a calculation of the […]

CMS BCRC and CRC NGHP Town Hall Updates

On April 1, 2021, CMS held its scheduled Town Hall with the Benefits Coordination & Recovery (BCRC) and Commercial Repayment Center (CRC) for Non-Group Health Plans (NGHP).  Although parts of the Town Hall included information that was already disseminated by CMS in the past, there were some specific highlights as noted below. Partial Resolution of […]

CMS Updates Life Tables for WCMSAs

Beginning March 27, 2021, CMS will convert to  the CDC’s “Table 1: Life Table for the total population: United States, 2018” for all Workers’ Compensation Medicare Set-Aside life expectancy calculations.  A link to the 2018 Life Tables can be found here.  The life tables are used by CMS to calculate the length of medical treatment […]

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CMS NGHP User Guide 6.2

In less than four months, CMS has issued three revised versions of the Non-Group Health Plan (NGHP) Section 111 User Guide.  The most recent version, Guide 6.2, includes some of the following updates: In Chapter IV, Section 6.7.1 of the Guide, CMS notes that those Responsible Report Entities (RREs) who can identify a future Ongoing […]

CMS News to Note

November was a busy month for CMS with the issuance of a new NGHP User Guide, Version 6.1 and multiple alerts.  Below is a brief summary of these updates.  2021 Recovery Threshold Alert On November 25, 2020, CMS issued a new alert on the 2021 Recovery Thresholds beginning on January 1, 2021.  The alert notes […]