To Submit or Not Submit: Exploring Facts Around Non Submit MSAs

Question mark drawn in white chalk on a rectangular chalkboard with a white frame.

Yesterday, as part of our complimentary knowledge series of webinars on Medicare Secondary Payer Compliance, we discussed the Centers for Medicare & Medicaid Services (CMS) submission process and the 2022 addition of Section 4.3 to the WCMSA Reference Guide, which addressed non-submit MSA options.

Each case is unique. A claimant’s age, pre-incident medical status, and post-incident treatment needs impact a future medical allocation. Adding jurisdictional requirements and norms and employer/insurer risk tolerance acceptance to the mix can make post-settlement medical considerations confusing and complicated.

During the presentation we offered clarification and insight on the following key points:

  • There are no statutory or regulatory requirements to submit an MSA to CMS. Submission to CMS is (and always has been) a voluntary process.
  • CMS released an updated WCMSA Reference Guide v3.5 in January of 2022 adding section 4.3 titled: “The Use of Non-CMS-Approved Products to Address Future Medical Care”. However, no changes to the MSP statute or regulations were made.
  • CMS revised Section 4.3 in March of 2022 (WCMSA Guide v3.6) to more accurately reflect CMS policy, process, and the law.
  • IMPAXX’s full suite of allocation services offers both submit and non-submit MSA options including our Non-Submit and Certified MSAs.

If you would like a link to the recorded webinar, have any questions, or wish to discuss how the IMPAXX team can review your options for future medical settlement and work with you to achieve an optimal outcome for final case resolution, please contact us at [email protected].