January 23, 2025 (Washington, DC) – The MARC Coalition today sent a letter to the Center for Medicare and Medicaid Services urging the Agency to reform its proposal to require entities settling claims with Medicare beneficiaries to report any “Medicare Set Aside” or MSA arrangements as part of the Section 111 process. The letter requested clarification about certain MSA reporting issues.
The MSA process has always been voluntary agreements in the workers’ compensation settlement context, and even CMS’s website recognizes that MSAs are private arrangements between settling parties and Medicare beneficiaries that are not addressed in law or regulation. While CMS has historically voluntarily offered to review and approve MSAs, they are not required arrangements. Moreover, many parties have opted to enter into private or “non-submit” MSAs.
“We do not believe that CMS has the actual authority to require MSA reporting, and the manner in which CMS is implementing its reporting requirements risks Medicare beneficiaries incorrectly being denied coverage for unrelated treatment,” said David Farber, counsel to the Coalition. “We urge CMS to reconsider its new reporting requirements and to instead draw upon the MSA data already in its possession, rather than require thousands of reporting entity to seek out data that CMS may already have.”
MARC looks forward to further engagement with CMS on this issue, and looks forward to further collaboration with the Agency to ensure the MSP program continues to benefit Medicare beneficiaries, the Medicare program and all other stakeholders.
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About MARC: The Medicare Advocacy Recovery Coalition (MARC) is a national Coalition advocating for the improvement of the Medicare and Medicaid Secondary Payer (MSP) programs. The Coalition advocates for reforms to improve the MSP system and the process for Medicare and Medicaid beneficiaries and affected companies. MARC’s goal is to ensure that all stakeholders are provided timely resolution of disputes and the fair reimbursement of claims involving secondary payer issues.