The Centers for Medicare and Medicaid Services (CMS) recently released an updated list of the Top 10 Submitter Errors, as well as a listing of helpful hints to avoid these recurring issues. The errors that have received the most attention include incomplete or insufficient medical treatment records for the last two years of treatment, and insufficient proof of drugs, dosages, and frequencies for the last two years of treatment.
While changes in CMS policy (i.e. prescription drug pricing and rated age requirements) have led the industry to seek out ways to reduce the cost of an MSA, this list is evidence that many Medicare Set Aside (MSA) submitters have lost sight of basic CMS requirements of a submitted Workers’ Compensation Medicare Set Aside Arrangement (WCMSA). In our experience as a qualified MSA allocator and professional administrator, we see many new and inexperienced allocators making these same mistakes, too. The lesson to be learned by this list is that the more qualified your MSA vendor is, the less likely you are to see a CMS rejection.
To view the “Top 10 Submitters Errors and Helpful Hints to Avoid Them” list, please click here.