What's New

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.

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.