CMS Lists How to Avoid 10 Top WCMSA Errors

The Centers for Medicare and Medicaid Services has now posted the 10 top errors on Workers' Compensation Set Aside Agreement submissions and how to avoid them:

1. No medical records for the last two years of treatment

2. Claims payment history missing or undated

3. Response to development requests incomplete

4. Calculation method stated as fee schedule when state does not have a fee schedule

5. Calculation method not stated for the medical set-aside

6. Total settlement amount missing or unclear

7. No rated age statement from submitter confirming that all rated ages obtained on the claimant have been included

8. Payout amount not used in annuity situations

9. Proposed medical set-aside amount is missing, unclear, or inconsistent with other information

10. Proposed prescription drug set-aside amount is missing, unclear, or inconsistent with other information

Click here for the solutions.