Jessica Taft, Author at Tower MSA Partners

CMS 2025 WCMSA Metrics Show Ongoing Decline in WCMSA Reviews and Rx Costs

December 10, 2025

CMS Metrics Show Ongoing Decline in WCMSA Reviews & Rx

The Centers for Medicare and Medicaid Services’ (CMS) newly released 2025 Workers’ Compensation Medicare Set-Aside (WCMSA) fiscal year statistics provide fresh insight into five years of CMS activity, comparing proposed MSA amounts with CMS-recommended (or “approved”) amounts.

This year’s data reveals a notable shift: CMS MSA recommendations – the number of completed reviews where CMS issues a recommended amount – have decreased by 12% since 2023 following a prior year increase. These insights offer valuable context for payers evaluating settlement strategies and benchmarking partner performance.

Below is a clear, easy-to-read summary of CMS’s latest data and how Tower’s results compare.

CMS MSA Recommendations are Down 12%

The agency provided five years of data covering 2021 to 2025 (CMS’s fiscal year ends on September 30), comparing proposed MSA amounts with CMS-recommended (often referred to as “approved) amounts. CMS MSA recommendations represent completed CMS reviews in which the agency issues the recommended amount needed to protect Medicare’s interest.

After a 9% increase in CMS MSA recommendations between 2022 and 2023, the 2025 data shows a 12% decrease in recommendations since 2023. The five-year average for CMS MSA recommendations is 14,611. No reason is provided for the decline; however, the end of Zero MSA reviews this past July likely contributed to this reduction.

Average MSA Amounts Hold Steady

The average CMS MSA amount increased slightly from $85,927 in 2024 to $86,169 in 2025, which is higher than the five-year average of $84,172.

A major trend persists: the widening variance between proposed and CMS-recommended amounts. In 2025, the variance reached 24% – the highest level in the past five years – resulting in more counter-highers to CMS MSA submissions.

Prescription Medication Costs Down; Treatment Costs Stable

Prescription drug costs have steadily decreased over the past five years. The average CMS-recommended amount is now $17,501—down 16% over the past five years. Treatment costs in the MSA have remained consistent year over year but are still up 13% over the five-year span.

How Tower’s MSAs Stack Up

Tower’s CMS-approved MSAs are consistently lower than the industry average CMS-approved MSAs, which is reflected in a comparison between CMS and Tower’s metrics.

Average Approved MSA (2025):

CMS: $86,169 Tower: $66,900

Tower’s average CMS-approved MSAs are 23% lower than the average CMS-approved MSA.

If we isolate just the prescription drug component of the MSA:

Average Rx Amount in MSA (2025):

CMS: $17,501 Tower: $11,701

Tower’s prescription drug allocations are 33% lower than the CMS average.

These metrics indicate that cost reductions are possible when payers select the CMS MSA approval process. Tower’s MSA allocation methodology and cost mitigation efforts, such as our Physician Follow-up service, effectively lower MSA allocations.

Why These Metrics Matter

CMS’s annual data release provides valuable transparency into review trends and serves as a helpful benchmark for the industry. Ultimately, partner performance drives payer outcomes. Tower’s results demonstrate that when clinical precision, compliance strategy, and operational execution come together, CMS approval can be both achievable and cost-effective.

If you have any questions, please contact Dan Anders, Chief Compliance Officer, at Daniel.anders@towermsa.com or 888.331.4941.

CMS to Host Webinar on CMPs on January 15

The Centers for Medicare and Medicaid Services (CMS) will host a webinar regarding Civil Money Penalties for NGHP Responsible Reporting Entities (RREs) on Thursday, January 15, 2026, at 2:00 p.m. ET. Per CMS:

The presentation by CMS will include reminders about the Final Rule and auditing process, anticipated correspondence, and a question-and-answer session.

Note, this is a different CMS webinar topic than the October 1, 2025, session on WCMSA reporting that was scheduled and canceled due to the government shutdown.

There is no pre-registration for the webinar. Full details, including instructions on submitting questions before the webinar, can be found here and in the “What’s New” section of the CMS website.

$1 Million Saved with Physician Peer Review

December 4, 2025

In Tower MSA Partners’ previous post, we explored “How Pre-MSA Triage Prevented $774k In Unnecessary Costs” by diagnosing issues before submission. This month, we move from prevention to precision. Through a comprehensive Physician Peer Review, Tower MSA Partners helped a client reduce projected MSA costs by more than $1 million, reinforcing how clinical oversight transforms both financial and compliance outcomes.

Identifying the Problem

The claim involved a long-term pain management case where the claimant had been prescribed multiple overlapping therapies and high-cost medications for years. On paper, everything appeared compliant, but Tower’s experienced analysts recognized red flags. The medications had not been re-evaluated for clinical necessity, and several treatments were duplicative or no longer consistent with current medical standards.

Left unchecked, the proposed MSA would have locked the payer into unnecessary costs for the claimant’s lifetime medical care. Beyond the financial impact, the payer also faced potential CMS scrutiny for including treatments without supporting clinical documentation. This is where Tower MSA Partners’ layered review process stepped in.

The Physician Peer Review Solution

Tower’s team initiated an independent Physician Peer Review, assigning the case to a licensed physician with expertise in pain management. The reviewer conducted a full analysis of the medical history, treatment progress, and prescription patterns. This deep clinical evaluation uncovered that several medications could be tapered or replaced with safer and lower-cost alternatives.

For example, the claimant was taking a combination of opioid medications that exceeded current best practice guidelines. The reviewing physician documented a detailed rationale for modification, providing evidence-based recommendations that were not only medically sound but also compliant with CMS expectations.

Once incorporated into the revised MSA, these adjustments reduced projected costs by more than $1 million while maintaining patient safety and treatment continuity.

Collaboration and Communication

One of Tower MSA Partners’ key strengths lies in its ability to bridge communication between medical reviewers, claims professionals, and legal teams. Rather than simply returning a report, Tower’s clinical experts walked the client through each recommendation, explaining how and why changes were appropriate. This transparency ensured that the payer, the defense attorney, and the treating physician were aligned before submission.

The final MSA reflected current medical necessity and included detailed documentation supporting each change. When presented to CMS, the submission received prompt approval with no development requests — a testament to the thoroughness of Tower’s process.

Why Oversight Makes the Difference

In MSA management, accuracy is everything. A single unchecked treatment plan can inflate costs by hundreds of thousands of dollars. Physician peer review adds a layer of expert validation that standard file reviews simply cannot provide. By ensuring that each projected medical service is both necessary and properly justified, Tower protects clients from avoidable financial and compliance risks.

This case demonstrates the tangible value of pairing clinical and administrative expertise. It also reinforces a key truth in the MSA industry: compliance and savings are not competing goals. When handled correctly, one strengthens the other.

Lessons Learned

Medical oversight pays off. Involving a physician reviewer early or mid-process can uncover inefficiencies that purely administrative reviews miss.
Documentation drives approval. Every modification included detailed clinical support, making CMS approval faster and more predictable.
Collaboration builds trust. Transparent communication between Tower, the client, and treating providers eliminated resistance and ensured everyone understood the reasoning behind the changes.
Savings reflect strategy. The $1 million reduction was not luck, it was the result of structured review protocols, experienced medical oversight, and Tower’s culture of precision.

Results That Reflect Expertise

Beyond the financial win, this case underscored Tower MSA Partners’ reputation for pairing clinical insight with regulatory mastery. The client achieved measurable ROI, CMS compliance, and peace of mind knowing that future medical allocations were realistic, defensible, and supported by clinical data.

Each peer review conducted by Tower is more than a medical check — it is a safeguard for payers, claimants, and settlements. This case serves as another example of how Tower delivers consistent, evidence-based results that protect both cost and care quality.

FAQs

What is a Physician Peer Review in MSA?
It is an independent medical evaluation that confirms treatment plans and medications in an MSA are clinically justified and aligned with CMS guidelines.

How does Peer Review reduce MSA costs?
By identifying unnecessary or outdated treatments and offering safer, evidence-based alternatives, peer review reduces total medical cost projections without compromising care.

Does CMS recognize Peer Reviews?
It’s important to combine the peer review with clinical oversight to document the changes to the treatment plan and medication regimen, which CMS will recognize.

When should an MSA include a Peer Review?
Any time a claim involves long-term treatment or high medication costs, a peer review should be performed before submission.

How Pre-MSA Triage Prevented $774K in Unnecessary Costs

November 4, 2025

In Tower MSA Partners’ recent blog post, “Why Case Studies Matter: Real-World Proof of MSA Savings,” we introduced this 12-month series demonstrating how Tower MSA Partners turns complex Medicare Set-Aside challenges into measurable savings and compliance wins.

Now, we’re diving into one of the most overlooked, and powerful, steps in the process: Pre-MSA Triage.

Before an MSA is ever submitted to CMS, Tower’s clinical and compliance teams perform an in-depth review that identifies unnecessary treatments, outdated medications, and questionable recommendations that inflate costs.

This early intervention isn’t just smart, it’s transformative. In one recent case, it prevented $774,000 in unnecessary costs before an MSA ever reached submission.

The Challenge: When “Wait and See” Becomes Expensive

For many payers, MSA management doesn’t begin until after a settlement is nearly complete. By then, most treatment plans and prescriptions have been in place for years, leaving little room to make meaningful changes.

Unfortunately, waiting too long can cause costs to spiral. We often see:

Outdated medical regimens that no longer reflect the claimant’s current condition
Duplicate or overlapping treatments prescribed by multiple providers
Inconsistent medical documentation that increases CMS scrutiny
Unnecessary or long-term opioid use that drives future cost projections

When these red flags go unaddressed, the resulting MSA can balloon to unrealistic levels, delaying settlements and unnecessarily tying up reserves.

Pre-MSA Triage changes that narrative.

Tower’s Approach: The Power of Early Insight

At Tower MSA Partners, Pre-MSA Triage is a strategic intervention process led by clinicians, compliance specialists, and pharmacists working collaboratively.

Here’s how it works:

Early Case Identification
As soon as a claim is identified as a settlement candidate, Tower’s team reviews the medical and pharmacy history to identify risk factors likely to inflate MSA costs. This includes duplicative and open-ended medications.
Clinical Analysis & Pre-MSA Triage Report
A clinical expert examines treatment appropriateness, drug utilization, and long-term projections and provides a Pre-MSA Triage report.
Claimant & Provider Communication
Tower facilitates direct communication with physicians to update treatment plans, discontinue unnecessary therapies, or substitute safer, more cost-effective options.
Final MSA Report
These clinical changes are incorporated into the full MSA report. The report gives adjusters and settlement teams actionable insights, providing a roadmap for CMS MSA submission and approval and settlement.

This proactive approach ensures that MSA allocations reflect actual, reasonable future medical needs, not inflated or outdated care plans.

Real-World Results: $774,000 Saved Before Submission

In one case, Tower MSA Partners was engaged to evaluate a complex workers’ compensation claim that had been open for years.

The initial Pre-MSA projection exceeded $900,000 due to:

High-cost brand-name medications
Redundant pain management treatments
Ongoing prescriptions that no longer matched clinical reality

Through Pre-MSA Triage, Tower’s team:

Identified outdated prescriptions no longer medically necessary
Coordinated with the treating physician to adjust the regimen
Applied evidence-based medical guidelines to revalidate care
Recalculated the MSA using corrected medical data

The result? A $774,000 reduction in projected future medical costs — achieved before the MSA was ever submitted.

The claim settled smoothly, with full CMS compliance and no delays.

This outcome demonstrates the power of collaboration, early action, and data-driven oversight. It also illustrates why Pre-MSA Triage is one of the most effective tools for balancing cost containment with patient care.

Lessons for Claims Professionals

The takeaway for insurers, TPAs, and self-insured employers is clear:
the earlier you intervene, the more control you have, both financially and clinically.

Key lessons include:

Start early. Integrating Pre-MSA Triage into claims workflows helps identify and correct costly issues before they compound.
Use clinical expertise. Medical professionals provide the insight needed to align treatment with guidelines and compliance requirements.
Collaborate often. Open communication among payers, providers, and Tower’s team ensures settlements move forward efficiently.
Document everything. A clear, defensible record of intervention builds confidence with CMS reviewers and reduces the risk of rejections or delays.

By applying these principles, payers gain greater control over outcomes, not just cost savings, but also improved accuracy, defensibility, and claimant satisfaction.

What’s Next: The Power of Peer Review

Pre-MSA Triage sets the stage for the next layer of cost containment, Physician Peer Review.

In our upcoming blog, “$1 Million Saved with Physician Peer Review: Here’s How,” we’ll explore how Tower’s network of medical specialists helped identify excessive treatment recommendations and achieve over $1 million in verified savings while maintaining full CMS compliance.

Stay tuned to see how medical oversight continues to transform outcomes for complex claims.

The Takeaway

Pre-MSA Triage isn’t just an optional step, it’s the foundation of effective MSA management.

By identifying risks early, Tower MSA Partners helps clients avoid inflated settlements, streamline CMS submissions, and achieve measurable cost reductions.

Each case tells a story of strategic collaboration and clinical excellence, and this $774K success is just the beginning.

Frequently Asked Questions

What is Pre-MSA Triage?
An early review that identifies outdated treatments and medications before an MSA is created.

Why does timing matter?
Starting early prevents inflated projections and costly surprises at settlement.

How does Pre-MSA Triage lower costs?
By removing unnecessary therapies and correcting medical or pharmacy issues that drive MSA totals up.

Do you contact treating physicians?
Yes, Tower works with providers to update treatment plans and discontinue unnecessary care.

Does this improve CMS approval?
Yes, cleaner medical records and updated care plans lead to smoother CMS submissions.

Is this only for big claims?
No, both routine and complex claims benefit from early clinical review.

How much can it save?
Savings vary, but reductions like the recent $774,000 example are common when outdated care is corrected.

Is this the same as Physician Peer Review?
No, Peer Review is the next level of clinical oversight used when specialty input is needed.

Why is Pre-MSA Triage important?
It sets the foundation for accurate, defensible, and cost-effective MSA outcomes.

Why Case Studies Matter: Real-World Proof of MSA Savings

October 7, 2025

Image of Tower MSA Partners Why Case Studies Matter series: Blog 1 Real-World Proof of MSA Cost Savings.

While Medicare Set-Asides (MSAs) are essential for compliance in certain workers’ compensation settlements, they can also lead to inflated costs if not carefully managed. Without proper oversight, unnecessary treatments, duplicate services, or overly conservative assumptions can cause MSA totals to rise dramatically. These inflated amounts not only delay settlements but also tie up resources that could be better used elsewhere.

At Tower MSA Partners, we help insurers, self-insured employers, and third-party administrators (TPAs) navigate this complex process with precision and cost control, ensuring settlements are compliant, efficient, and fair.

This kickoff blog launches a 12-month series of real-world case studies demonstrating how proactive strategies, clinical expertise, and deep regulatory knowledge deliver measurable savings and smoother claim resolutions.

Common MSA Challenges

For many claims professionals, MSAs can feel like a “black box.” The process often seems like paperwork sent off to CMS, followed by a waiting game for approval. This lack of transparency can lead to missed opportunities for cost savings and compliance improvements.

Here are a few recurring challenges we see: – Unnecessary treatments or duplicate costs included in MSA submissions – – inconsistent and contradictory treatment patterns – Lack of early intervention to address treatment plans before they escalate – Missed opportunities to optimize claims for both cost control and compliance

These issues affect everyone involved—from injured workers to payers. Through detailed case studies, this series will show how a strategic, proactive approach prevents these challenges and leads to better settlement outcomes.

Real Savings, Real Impact

The strength of this series is in real numbers and real results. In the coming months, we’ll highlight outcomes such as: – $774,000 saved by identifying and resolving issues before MSA submission – $1 million saved through a physician peer review that corrected unnecessary treatment recommendations – $98,000 saved with a second-opinion MSA review before finalizing settlement

These results represent actual cases handled by Tower MSA Partners. They demonstrate how compliance and cost containment can work together to protect Medicare’s interests while avoiding overfunding.

Why Case Studies Matter

Every claim is unique, yet the challenges surrounding MSAs are surprisingly consistent across the industry. Factors like rising medical costs, evolving CMS guidelines, and the push to close claims quickly create a complex balancing act.

Through these case studies, Tower MSA Partners aims to: – Improve the quality and defensibility of MSA submissions – Speed up settlements by eliminating preventable delays – Lower claim costs without compromising care – Provide clarity and confidence for claims professionals handling complex cases

When payers understand why certain costs are included and how they can be managed, they make smarter, more informed decisions that benefit their organization and the injured workers they serve.

What’s Ahead in the Series

Each month, we’ll release new content focusing on a specific area of MSA management, including: – Early Intervention Strategies – Preventing inflated costs before an MSA is created – Physician Peer Review – Validating treatment plans and prescriptions – Compliance Best Practices – Reducing the risk of CMS penalties and rejections – Ongoing Claim Management – Preventing cost creep over time – Legacy Claim Resolution – Closing backlogged claims to free reserves and improve efficiency – Case Optimization and Review – Streamlining processes to improve accuracy and outcomes

The series will conclude with a Top 10 Lessons Learned wrap-up blog summarizing a year’s worth of data and insights for claims professionals and legal teams.

The Takeaway

MSAs don’t have to be overwhelming or overly expensive. With the right approach, organizations can achieve compliance, control costs, and resolve claims efficiently. This series will provide real-world proof of how Tower MSA Partners helps clients reach these goals, step by step.

Stay tuned for our first in-depth case study, where we’ll explore how early intervention prevented nearly $800,000 in unnecessary costs and paved the way for a smooth, compliant settlement.

Frequently Asked Questions

What causes Medicare Set-Asides to become inflated?
Inflated MSAs often come from unnecessary treatments, duplicate services, outdated prescriptions, or conservative medical assumptions that were never updated.

Why do MSA case studies matter?
They show real savings and real outcomes so payers can understand how proactive MSA strategies improve accuracy, compliance, and cost control.

What are the most common challenges in MSA preparation?
Unnecessary care, inconsistent documentation, lack of early intervention, and missed opportunities to correct treatment plans.

How does Tower MSA Partners reduce MSA costs?
Through early clinical review, pharmacy analysis, physician communication, and regulatory expertise that remove unnecessary or inaccurate costs.

Who benefits from proactive MSA management?
Claims adjusters, TPAs, self-insured employers, risk managers, and injured workers all benefit through faster, cleaner, and more cost-effective settlements.

How much can proactive MSA strategies save?
Savings vary, but real cases show reductions such as $774,000 saved before MSA submission and $1 million saved via physician peer review.

Does improving MSA accuracy slow down settlements?
No. Addressing medical and documentation issues early creates smoother CMS approvals and eliminates preventable delays.

What topics will this 12-month case study series cover?
Early intervention, physician peer review, compliance best practices, legacy claim resolution, and prevention of medical cost creep.

How does this series help claims professionals?
It provides transparent examples, clearer processes, and actionable steps for improving accuracy, compliance, and settlement outcomes.

Beat the Clock: Section 111 Reporting Checklist Before Audits Start

September 30, 2025

Tower MSA Partners October Webinar prepare you for CMS Section 111 audits in 2026.

Starting in Q1 2026, the Centers for Medicare and Medicaid Services (CMS) will begin quarterly Section 111 reporting audits and is expected to issue financial penalties for non-compliant payers. What has been “coming soon” for years is now a reality, and the clock is ticking.

Join Dan Anders, Tower MSA Partners’ Chief Compliance Officer on Wednesday, October 22, at 2 pm ET, for a practical, actionable session designed to make sure your reporting is audit-proof. Dan will also provide an update on Workers’ Compensation Medicare Set-Aside (WCMSA) Section 111 reporting.

Here’s what you’ll learn:

Key criteria & timelines for Section 111 penalty implementation.
Final reporting checklist to eliminate errors and avoid penalties.
How CMS Section 111 reporting audits identify errors and blind spots and how to correct them.
Critical updates on Workers’ Compensation MSA reporting, and common pitfalls that lead to penalties

Date: Wednesday, October 22

Time: 2:00 PM ET

Register Here

Bring your toughest questions – a live Q&A session will follow the presentation. You may also submit questions ahead of time during registration.

Please click the link above and register today!

Please note that no CEU credit is offered for this webinar.

Rockstar Careers: Finding Your Rhythm in Workers’ Comp

September 3, 2025

Tower MSA Partners shares career journeys and leadership lessons from WCI TV interviews at the 2025 Workers’ Compensation Institute Conference.

Highlights from WCI TV at WCI 2025

Once again, Tower MSA Partners proudly sponsored WCI TV at the Workers’ Compensation Institute’s Annual Conference in Orlando, held August 17–20, 2025. Each year, WCI TV shines a spotlight on the people and ideas shaping the workers’ compensation community. This year’s theme, “Rockstar Careers: Finding Your Rhythm in Workers’ Comp,” invited industry leaders to share the unexpected ways they found their way into the field and the lessons they’ve learned along the way.

The conversations revealed humor, heart, and the shared passion that keeps this community strong. Below are highlights from the inspiring interviews.

Dan Anders – Tower MSA Partners

As Tower MSA Partners’ Chief Compliance Officer, Dan Anders is no stranger to the spotlight at WCI. He kicked off this year’s series by reflecting on how is own career path began outside the industry, in politics and law, before a colleague introduced him to workers’ compensation. What began as an unexpected opportunity turned into a 23-year journey.

“I didn’t know anything about it, but I needed a job. That began my 23-year journey in workers’ compensation.”

When asked what advice he’d give to those considering the field, Dan emphasized both sides of the practice—helping injured workers as a plaintiff’s attorney or solving problems as defense counsel. Either way, he said, it’s a career that offers variety and purpose.

Dan also credited mentors for shaping his path, from his first law firm partner who handed him his first Medicare Set-Aside file, to Tower’s retired CEO Rita Wilson:

“She exemplified how a Medicare compliance company can provide an exceptional level of customer service… and really make the lives of our client partners easier.”

Watch Dan’s full interview

Patti Colwell – Southwest Airlines

With 30 years at Southwest Airlines, Patti Colwell knows what it takes to build a career that lasts. Now the Manager of Workers’ Compensation Programs nationwide, Patti confessed she never sought out this career—it found her.

“I didn’t pick workers’ comp, it picked me. My boss said, ‘Boy, have I got a deal for you.’”

Over the last 25 years, she’s developed an approach centered on problem-solving and empathy. Patti stressed the importance of being flexible:

“You have to be able to live in the gray area. Even though it’s regulated… you may have to think outside those regulations to find the right solution and do the right thing.”

Keys to success, she added, include lifelong learning, compassion, and the ability to have tough conversations while still offering solutions. Patti credited her VP in Southwest’s People Department for giving her the confidence to take on workers’ comp in the first place:

“Because of her support, that really gave me the confidence boost I needed to say, ‘Yeah, I can do this.’”

Watch Patti’s full interview

Greg Hamlin – Berkley Industrial Comp

Greg Hamlin, Chief Claims Officer at Berkley Industrial Comp, oversees claims in some of the nation’s riskiest industries—construction, mining, and other high-hazard environments. But his career started far from insurance.

“As a kid, I wanted to do theater. Then I spent a couple years on the Navajo reservation and realized I loved giving back. Eventually, Liberty Mutual recruited me out of college.”

For Greg, workers’ comp is about stability, service, and impact:

“We’re meeting people on their worst days, and we’re helping them get back to work and recover.”

His advice to newcomers is practical and encouraging:

“It’s a very stable industry with lots of opportunity. You get to play in a lot of different sandboxes—law, finance, medicine—and really help people.”

Greg also shared wisdom passed down from a mentor who left a lasting impression:

“He always said, ‘Always think in a positive manner.’ In this industry, where we meet people in their darkest moments, that mindset really matters.”

Watch Greg’s full interview

Brenda Chitty – NARISK

For Brenda Chitty, Assistant Director of Workforce Development at NARISK, workers’ comp is about service at every level—injured workers, clients, and partners. Like many, she didn’t plan on the field; it found her.

“Workers’ compensation found me. I started in disability case management and then moved into a trucking company’s comp department—and I never left.”

Her advice for newcomers is rooted in humility and purpose:

“Make sure you want to be a servant. Workers’ compensation is about taking care of people. When you do, you’ll find it very rewarding.”

For those already a few years into the field, Brenda’s encouragement was simple but powerful:

“Stick it out. Stay true to who you are and what you know. Someone is counting on you.”

Brenda also credited her parents, who ran a furniture store, for teaching her customer service from an early age:

“I learned how to treat people from the age of four to 21. My parents were my biggest heroes.”

Watch Brenda’s full interview

Bryan Conner & Drew Cashatt – American Airlines

Perhaps the most dynamic interview came from Bryan Conner and Drew Cashatt of American Airlines, whose friendship and shared leadership embody the theme of servant leadership.

Bryan, once a flight attendant, pivoted into workers’ comp after realizing injured colleagues needed stronger advocacy:

“A flight attendant came into my office and said, ‘I’ve been injured and I needed more help.’ I took that as my life’s mission—to create an advocacy-based workers’ comp program.”

Drew’s path began loading luggage for TWA while in law school before he found his way into accommodations and workers’ comp. Both now lead programs designed to holistically support injured team members.

Their advice? Servant leadership.

“Be a servant to those injured workers. They’re at the lowest point in their lives. Advocate for them and help them recover successfully.” —Drew

Perhaps the most touching moment came when Bryan named Drew as the person who most impacted his career:

“You’re sitting right beside me. He is a servant leader, and together we know we can make a difference.”

Drew echoed the sentiment, underscoring the bond the two share as colleagues, accountability partners, and friends.

Watch Bryan & Drew’s full interview

Key Themes Across the Interviews

Across each conversation, a few themes rang loud and clear:

Workers’ comp chooses you: Almost everyone admitted they didn’t plan for this career—it found them.
Service is the core: Whether in airlines, TPAs, or insurers, the heartbeat of workers’ comp is caring for people during difficult times.
Mentors matter: Each speaker credited mentors, colleagues, or family for shaping their journey.
Adaptability and empathy: From “living in the gray area” to “always thinking positive,” success in this field requires both skill and heart.

Conclusion

The 2025 WCI TV “Rockstar Careers” series reminded us that workers’ comp is more than rules and claims—it’s a people business, built on service, resilience, and leadership. Each story revealed not just a career path, but a calling. Together, they form a chorus that makes this industry stronger, more compassionate, and, yes, a little more rock-and-roll.

Tower MSA Partners Sponsors WCI TV for Seventh Year: Spotlight on “Rockstar Careers” in Workers’ Comp

August 13, 2025

Tower MSA Partners Is The Proud Sponsor of WCI TV Rockstar Careers In Workers Comp at the 2025 WCI Conference.

Tower MSA Partners is once again proud to sponsor WCI TV during the Workers’ Compensation Institute’s Educational Conference, August 17-20 in Orlando, Florida. This marks our seventh consecutive year partnering with WCI TV to share inspiring stories and perspectives from across the workers’ compensation community.

This year’s WCI TV theme, “Rockstar Careers: Finding Your Rhythm in Workers’ Comp,” takes viewers backstage to explore the unique and often unexpected career paths that lead people into this industry. Through a series of engaging interviews, industry professionals will share how they discovered workers’ compensation, the moments that shaped their careers, and the advice they’d give to those considering, or just starting, a career in this field.

These conversations will also pull back the curtain on what makes the workers’ comp industry such a fulfilling place to work. Viewers will hear surprising facts about the profession, candid insights on how to excel, and powerful stories of the real-life impact professionals have made on injured workers and their families.

“Workers’ compensation is an incredibly rewarding field that blends complex problem-solving with the opportunity to truly make a difference in people’s lives,” said Dan Anders, Chief Compliance Officer of Tower MSA Partners. “We’re excited to help share these stories through WCI TV and, hopefully, inspire the next generation of industry rockstars.”

In addition to sponsoring WCI TV, Anders will moderate the session “MSP Compliance and CMS Updates” on Tuesday, August 19. The panel will address the latest Medicare Set-Aside and settlement developments, offering practical strategies for claims professionals, attorneys, and other stakeholders.

Catch the “Rockstar Careers” segments on WCI TV throughout the conference in the exhibit hall, on the WCI conference app, and online. Whether you’re a seasoned professional or new to the industry, these stories will resonate, and maybe even strike a chord you didn’t expect.

Does My Settlement Qualify for a Zero MSA?

August 5, 2025

As the final post in our Do I Need an MSA? series, we turn to $0 MSAs. While CMS no longer reviews and approves $0 MSAs, they remain a legitimate and strategic option in specific settlement scenarios. And when a $0 MSA is appropriate, the parties can settle with the confidence that Medicare’s interests are protected as well as the injured workers’ access to Medicare to pay for treatment.

But when exactly is a $0 MSA appropriate?

Let’s explore.

What Is a $0 MSA?

A $0 Medicare Set-Aside (MSA) allocates no funds for future Medicare-covered medical expenses related to the claimed workers’ compensation injury. In short, it means the settling parties believe either that the denied nature of the claim means Medicare is primary for future medical or, if an accepted claim, that there is no further need for injury-related treatment or medications.

While this sounds simple, CMS requires specific criteria to be met and supported by documentation to ensure that Medicare’s interests are still being considered appropriately. After all, even a $0 allocation must be defensible.

When Is a $0 MSA Appropriate?

The Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide, Section 4.2, outlines the situations in which a $0 MSA is appropriate. Below are the scenarios:

The Claim Is Denied and No Medical or Indemnity Payments Have Been Made

This is the most straightforward situation:

The insurer has not paid any medical or indemnity benefits (except for investigational purposes) prior to settlement,
The claim remains fully denied, and
The settlement does not allocate funds for future or past medical.

Denied Claim with Prior Payments

If some medical payments were made early in the life of the claim, but the carrier later issued a formal denial and maintained it throughout, a $0 MSA may still be possible. Criteria to be met:

The claim was denied,
Denial was within state statutory timeframe allowed to pay without prejudice, and
The settlement does not allocate funds for future or past medicals.

Court Decision on Compensability of Claim or Ongoing Medical

If a court, commission or board finds after a hearing on their merits that either the claim is not compensable or that the employer does not owe additional medical or indemnity benefits, then a $0 MSA is applicable. The payer needs to ensure that they abide by such a decision in terms of not paying for additional medical or indemnity short of a compromise settlement.

Injury-related Medical Condition Has Resolved

In some cases, the injured worker may have recovered fully, no longer receives treatment, and no further Medicare-covered services are anticipated. Even if the claim was accepted at one time, a $0 MSA may be appropriate if:

There is sufficient medical evidence to support full recovery,
The treating provider documents that no future treatment is required,

CMS Policy Change: $0 MSA Submissions No Longer Reviewed After July 17, 2025

As noted above, effective July 17, 2025, CMS no longer reviews $0 MSA submissions. This change reflects a shift in resource prioritization: CMS sees limited value in reviewing MSAs that allocate no funds to future medical.

However, this does not remove the obligation to protect Medicare’s interests. Instead, the burden falls more squarely on the settling parties to:

Evaluate whether a $0 allocation is appropriate,
Document the justification thoroughly, and
Retain that documentation as evidence of compliance.

At Tower MSA Partners, we anticipate this shift will increase the importance of clear documentation and expert evaluation. Without CMS review, you need a partner who can help you build a strong, defensible case for a $0 MSA.

Documentation Checklist: Building a Defensible $0 MSA

To support a $0 allocation, especially in a post-CMS review environment, be sure to compile the following:

Denial Letter (for a denied claim) – Official claim denial from the payer
Claim Payment History – Showing medical, indemnity and expense payments
Medical Records (for an accepted claim) – Indicating no ongoing or anticipated treatment
Legal Documents – Any court orders or other legal documents pertinent to the denial or need for ongoing and future injury-related medical care.
Physician Statement – If applicable, confirming no future medical care is necessary

This documentation can be provided for Tower to review and prepare a report that confirms the case meets CMS $0 MSA criteria.

How Tower MSA Partners Can Help

Tower’s experienced team brings together clinical, legal, and claims expertise to:

Evaluate whether a $0 MSA is appropriate,
Provide recommendations to obtain a valid $0 MSA,
Prepare a clear and defensible report, and
Help to explain CMS’s $0 MSA criteria to settling parties and assist with appropriate settlement language.

Final Thoughts: The Power of Zero—When Used Wisely

A $0 MSA can be a powerful tool in the settlement process, helping to close claims quickly and reduce costs. But like all compliance strategies, it must be used wisely.

As CMS steps back from $0 MSA reviews, the responsibility for Medicare compliance falls squarely on the parties involved. Tower MSA Partners is here to guide you.

Ready to Evaluate a Zero MSA?

Let us help you determine whether your settlement qualifies for a $0 MSA, and make sure it’s documented the right way.

Contact Tower MSA Partners today to schedule a consultation.

Decoding CMS Development Letters: Prevention, Trends, and Effective Responses

July 2, 2025

Avoid CMS Development Letter Delays: Learn How in Our Upcoming Webinar

The Centers for Medicare & Medicaid Services (CMS) continues to issue an increasing number of CMS Development Letters following Medicare Set-Aside (MSA) submissions, and not all of them make sense. While some requests are warranted, many appear unnecessary, resulting in delays, frustration, and additional work for claims teams.

At Tower MSA Partners, our strategy has always been to prevent Development Letters before they happen. Even with meticulous planning, CMS sometimes requests additional documentation to finalize its review. That’s why it’s critical to know how to anticipate, address, and respond to these letters when they arrive.

Join us for a live webinar on July 23, 2025, at 2:00 p.m. ET as Tower’s Chief Compliance Officer, Dan Anders, and CMS Submission & MSP Compliance Manager, Brittany Wilkerson, break down:

- - The most common CMS Development Letter requests you can expect
  - Unusual and emerging requests CMS is making
  - Proactive steps to prevent Development Letters
  - How to partner with Tower to avoid or quickly resolve these requests

You’ll also have the opportunity to submit questions in advance to be answered live during the session.

Don’t let CMS Development Letters slow down your settlement process.

Register