CMS Updates WCMSA Reference Guide; Now Allows Amended Review for MSA Determinations up to 6 Years Old
Heather Sanderson
October 31, 2019

CMS has released an updated WCMSA Reference Guide version 3.0. It can be found here.  The two significant changes are 1) CMS extending the Amended Review period from 4 to 6 years (Section 16.2), and 2) As of April 1, 2020, the required language for the signed consent form to submit an MSA to CMS now must include a statement that the WCMSA arrangement need and process has been explained to the claimant and that the claimant approves of the contents of the submission (Section 10.2). Regarding the extended timeline for submission of Amended Reviews, we applaud CMS for granting the extension of this process for MSA determinations up to 6 years old.

A full list of the other less noteworthy changes are the following:

  • Addresses have been corrected or clarified for reporting workers’ compensation cases; for sending yearly WCSMA account attestations; and for sending WCMSA proposals, final settlements, and re-review requests (Sections 2.2, 17.5, and 17.6).
  • “Death of a Claimant” information has been updated and standardized with the Self-Administration Toolkit for WCMSAs (Section 19.2).
  • CMS’ expectations for competent administration of WCMSA funds when “frequently abused drugs” are prescribed for a claimant have been clarified, with policy and guidance link added (Sections 17.1 and 17.3).
  • CMS has clarified how hospital fee schedules are determined (Section 9.4.3).
  • The Life Table link has been updated (Section 10.3).
  • This guide has been updated to account for changes in the WCMSAP, which now includes a Professional Administrator role, which can upload account transactions and view account details, and the ability to submit attestations online for all others (Section 17.6; minor changes throughout).