Workers Comp Medicare Set Aside reporting was required for all Workers Comp claims effective 01/01/2011. My last post was taken from the CMS memo from 2008. I wanted to point out a few areas from the memo that should concern all employers.

If you are not in compliance the fine is "a civil money penalty of $1,000 for each day of noncompliance for each individual for which the information under such subparagraph should have been submitted."

That is an astounding amount of money even for one file. For instance, one file not reported for six months would result in a fine of $180,000. With the Feds having a budget shortfall, this could be a cash cow for CMS.

One of the other questions we have come across is concerning offshore accounts such as captives and risk retention groups. I have been told by various MSA experts and the CMS that if the claim originated in the US, regardless of where the policy was initiated, the claims that reach the minimum thresholds must be reported to the CMS or be subject to the fines. I discussed these minimum thresholds in this post.

The other concern that I have is that the CMS has often said it is the ultimate responsibility of the employer to report the claims. Are you sure that your carrier or TPA has reported your claims timely and accurately? I have often heard that "our carrier or TPA" has that handled.

I will cover more on this topic in the next post.