Automation is Essential with the New WCMSA S111 Reporting Requirements

With the April 2025 CMS updates to Section 111 (S111) Mandatory Reporting, claims organizations are facing a new era of complexity. The expanded requirements for Workers' Compensation Medicare Set-Aside (WCMSA) data reporting-along with stricter enforcement and audit protocols-are pushing many teams to rethink how they manage compliance.

The challenge: Rising complexity meets shrinking bandwidth

The new S111 reporting directives require detailed WCMSA data in TPOC reports, including:

• MSA Amount and Period
• Payout Type (Lump Sum vs. Structured)
• Initial and Annual Deposits

These changes come at a time when many claims teams are already stretched thin. The industry is grappling with:

• Workforce turnover and retirements, leading to loss of institutional knowledge
• Skill gaps in regulatory expertise and data management
• Increased claim volumes and tighter timelines
• Risk of penalties for noncompliance or delayed reporting

Manual processes simply can't keep up and may leave too much to chance. That's where automation becomes not just helpful-but critical.

Solving real-world challenges with automation

Imagine transforming your S111 data into a fully automated compliance engine-powering your Medicare Secondary Payer (MSP) protocols from end to end. This can not only mitigate risk and reduce delays in settlement but also relieve adjusters from complex tasks that often require significant time and attention-freeing them to work on higher-impact work.

With Verisk's automation suite, you gain these advantages:

• Real-time compliance monitoring empowers teams to track reporting status and resolve issues before they escalate.
• Automated data capture reduces manual entry errors and helps ensure timely CMS submissions.
• System integration and workflow efficiency minimize disruption and support scalable automation.
• Low-dollar settlements - MSA optimization helps teams manage cost and compliance for settlements under CMS thresholds.
• Proactive claim identification helps ensure no eligible claim is missed, reducing audit exposure.

See how you can turn automation from a compliance strategy to a competitive advantage

Verisk's automation suite: Purpose-built for S111 compliance

Verisk offers a comprehensive suite of automation tools designed to address the toughest challenges in S111 reporting and WCMSA management:

Bridging the workforce gap with technology

As experienced claims professionals retire and new talent enters the field, automation helps bridge the gap as it:

• Standardizes processes across teams, reducing reliance on individual expertise
• Accelerates onboarding for new staff by embedding compliance into workflows
• Reduces burnout by eliminating repetitive tasks and allowing teams to focus on strategic work
• Supports scalability as organizations grow or restructure

Final thoughts

The new S111 protocols are a turning point for the industry. With CMS demanding more data, faster-and with greater accuracy-claims organizations must evolve. Verisk's automation tools offer a powerful, integrated solution to meet these demands while addressing workforce challenges and future-proofing operations.

Verisk is the first provider offering a fully automated, end-to-end MSP compliance solution-setting a new standard for efficiency, accuracy, and risk mitigation.