WCMSA Reporting Issues Seen Post-Rollout

Five months into mandatory WCMSA reporting, issues are evident in the rollout, particularly for those workers’ compensation Responsible Reporting Entities (RREs) who rely heavily on Medicare’s voluntary Medicare Set-Aside (MSA or WCMSA) submission process.
Among the issues is that Medicare’s Workers’ Compensation Review Contractor (WCRC) has ceased review of in-progress WCMSA submissions in instances where a Section 111 report has been transmitted by the RRE with a settlement amount populated, or a TPOC report, according to the Sanderson law firm.
“For clients who prefer our non-submit, indemnified MSAs, you are simply not seeing many of these issues because they largely stem from overly rigid ‘exact match’ coding by Medicare for data populating these seven new WCMSA reporting fields,” according to the blog.
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Sedgwick chief claims officer, Max Koonce, sees four “hot topics” shaping the future of workers’ compensation, that are influencing how injuries are prevented, managed and resolved.
In a company blog post this week, Koonce highlighted the aging workforce as the top issue, as the firm’s data shows that last year logged the biggest annual increase in workers’ compensation claims came from employees aged 60 and older, up 2.8% from 2023.
Mental health is another key issue. Although only 2% of claims currently involve a mental health component, these claims cost 3.5 times more and last 3.6 times longer than those without.
On the legal front, Koonce noted that the principle of workers’ compensation as an exclusive remedy is facing increased scrutiny.
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New York State Insurance Fund (NYSIF), the not-for-profit workers’ compensation insurer, is launching a podcast series, NYSIF FUNDamental.
Podcast episodes will cover worker safety, climate change, mental wellness, finance, technology and other timely topics.
“NYSIF FUNDamental provides an exciting opportunity for NYSIF to explore and highlight key issues that are foundational to support our mission of service and safeguard the well-being of New Yorkers,” said Gaurav Vasisht.
New episodes of NYSIF FUNDamental will be released at regular intervals throughout the year, and will be available on Apple Podcasts, Spotify, and YouTube, as well as most podcast platforms.
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