Workers' Compensation Medicare Set Aside Arrangements (WCMSA) What's New
Guidance for new information regarding upcoming Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) changes.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 09, 2019
New information regarding upcoming Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) changes are posted as the information becomes available. Items remain on this page for the current year and are then moved to the Archive page.
June 3, 2025 - Use of the Center for Disease Control (CDC) 2022 Life Tables
Beginning June 14, 2025, CMS will utilize the CDC’s “Table 1: Life Table for the total population: United States, 2022” for the Workers’ Compensation Medicare Set Aside life expectancy calculations. A link to the CDC’s 2022 Life Tables can be found in the Related Links section at the bottom of this page.
May 29, 2025 - CMS to Host Introduction to Workers Compensation Medicare Set Asides (WCMSAs) Webinar
CMS will be hosting an Introduction to WCMSAs webinar. The intent of this webinar is to go over the basics of WCMSAs including purpose, submission guidelines and administration as well as to offer some WCMSA best practices. Full webinar details can be found in the announcement located in the Download section below.
April 7, 2025 – Updated Workers’ Compensation Medicare Set Aside (WCMSA) Reference Guide Now Available
The WCMSA Reference Guide version 4.3 is now available in the Download section of the Workers’ Compensation Medicare Set Aside Arrangements page.
April 7, 2025 – Updated Self-Administration and You: A Beneficiary Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements (WCMSAs) Now Available
The Self-Administration and You: A Beneficiary Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements (WCMSAs) is now available in the Download section of the WCMSA Self Administration page.
January 21, 2025 – Upcoming Changes to Workers’ Compensation Medicare Set-Aside (WCMSA) Process
Based on review of current WCMSA guidance and feedback from the WCMSA community, CMS will be implementing the following changes in the first half of 2025.
Amended Reviews: Currently, amended review requests cannot be submitted until 1 year after a WCMSA case has been approved. Effective April 7, 2025, amended review requests will be allowed at any time after a WCMSA case is approved.
Zero-Dollar Set-Asides: Effective July 17, 2025, CMS will no longer accept or review WCMSA proposals with a zero-dollar ($0) allocation. Entities should still consider the parameters available in the WCMSA Reference Guide (PDF) to determine whether a zero-dollar WCMSA allocation is appropriate and should maintain documentation to support that allocation.
January 16, 2025 – Updated Workers’ Compensation Medicare Set Aside (WCMSA) Reference Guide Now Available
The WCMSA Reference Guide version 4.2 is now available in the Download section of the Workers’ Compensation Medicare Set Aside Arrangements page.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.