Liability Claims MSA Report Now Required By CMS
The Liability Claims MSA reports are now due. The data for Workers Comp Medicare Set Asides (WCMSA or MSA) were supposed to be reported to the CMS by January 1, 2010 by insurance carriers, TPA’s or employers. There was a little confusion as to which claims were to be reported.
The next group of claims that must be reported by January 1st, 2011 is all liability claims MSA. The “liability claims” moniker has caused confusion on which claims need to be reported. In other words, what does the CMS consider a liability or a no-fault claim?
This is straight from the CMS regs:
Liability insurance means insurance (including a self-insured plan) that provides payment based on legal liability for injury or illness or damage to property. It includes, but is not limited to, automobile liability insurance, uninsured motorist insurance, underinsured motorist insurance, homeowners’ liability insurance, malpractice insurance, product liability insurance, and general casualty insurance.
No-fault insurance means insurance that pays for medical expenses for injuries sustained on the property or premises of the insured, or in the use, occupancy, or operation of an automobile, regardless of who may have been responsible for causing the accident. This insurance includes but is not limited to automobile, homeowners, and commercial plans. It is sometimes called “medical payments coverage”, “personal injury protection”, or “medical expense coverage”.
The CMS has self insurance for liability covered very well:
Self-insured plan means a plan under which an individual, or a private or governmental entity, carries its own risk instead of taking out insurance with a carrier. This term includes a plan of an individual or other entity engaged in a business, trade, or profession, a plan of a non-profit organization such as a social, fraternal, labor, educational, religious, or professional organization, and the plan established by the Federal government to pay liability claims under the Federal Tort Claims Act. An entity that engages in a business, trade, or profession is deemed to have a self-insured plan for purposes of liability insurance if it carries its own risk (whether by a failure to obtain insurance, or otherwise) in whole or in part.
I think they have it covered for the most part. I do not see CMS allowing any exceptions. They even have homeowners’ liability listed. The self insurance part includes self insurance even if there was a failure to obtain insurance.
Workers Compensation is a little more straightforward in this area. The liability requirements are very complex. If you are not sure if your claim or set of claims should be reported to the CMS, please feel free to email me at [email protected]
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