The Upcoming MSA Crisis
Is an MSA crisis upcoming? I am not a Medicare Set Aside Agreement (MSA) expert. There are few people that actually are overall. The one concern I have is that I do not think all participants are compliant with the reporting requirements by the MSA.
The Centers for Medicaid/Medicare (CMS) had delayed the upload of the claims data for months on end. I am under the impression they were also not ready for the task at hand. Handling that much data all at once equals crashed servers. It is the same as trying to access a very popular news article. The servers could never handle that much info.
My main point here is the deadline for reporting Workers Compensation claims that fall under the guidelines (see my last post) must have been reported by 1/1/11. The fine for not reporting is $1,000 per incident. The CMS memo is in my next post.
If one looks on the CMS MSA website, there is a complete website for the reporting requirements. I used to be a computer systems engineer many years ago. One of the most arduous tasks was converting data for another party to use. The normal rejection rate for a first pass upload is approximately 10%.
The other side of the coin is what companies are required to upload data. My understanding is any type of property and casualty claim, which encompasses Workers Compensation. I am wondering about:
- TPA’s – is it the responsibility of the TPA’s or the employer?
- Onshore Captives
- Offshore Captives
- Risk Retention Groups
- Holding Companies
- PEO’s
I could list many more. The bottom line is that someone has to upload the data. My question is who has the final responsibility even if you have a regular insurance carrier? From what I have read, it is the employer’s ultimate responsibility regardless.
How does an employer know the data that was uploaded is accurate? What if not all claims are uploaded to the CMS as is required? I could go on and on with questions.
I will not geek out and get into the data structures. The best thing to remember (in my opinion) is you need to have a good consultant supervise all of the data uploads to CMS.
If anyone reading this has questions, please feel free to email me at [email protected] or call me at (800) 813-1386.
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