The Centers for Medicare & Medicaid Services (CMS) through various Memorandums and guides, has clearly stated that “[w]hile there are no statutory or regulatory provisions requiring that a (Workers’ Compensation Medicare Set Aside) WCMSA proposal be submitted to CMS for review, submission of a WCMSA proposal is a recommended process.” Of significant note, the word is recommended; not required. However, there are jurisdictions which have implemented a condition for approval of a workers’ compensation settlement: that if one of CMS’ established work review thresholds are met, the WCMSA must be submitted to CMS [1]. Nebraska has been such a jurisdiction, for which the Nebraska Workers’ Compensation Court formally released “Guidelines for Medicare Set-Aside Arrangements in Lump Sum Settlements [2]” which explicitly required that if one of the thresholds were met, CMS submission of a WCMSA was…
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