HR Tips

CMS guidance: Section 111 threshold and user guide updates and FY2025 WCMSA stats

Last month,the Centers for Medicare and Medicaid Services (CMS) released an updated Section 111 NGHP User Guide (Version 8.2, October 6, 2025). Changes include Chapter III (Policy) Chapter IV (Technical Information), and Chapter V (Appendices). Notably, changes address single settlements with multiple incidents, Work Comp Medicare Set-Asides (WCMSA) reporting for settlements covering multiple claims, and multiple settlements for the same individual.

In an alert, CMS confirmed that the current $750 low-dollar reporting and recovery threshold for 2026 will remain.

A new chart, Workers' Compensation Medicare Set-Aside (WCMSA) Fiscal Year Statistics 2025 presents comparative data for FY 2021 - 2025.

EEOC issues national origin bias guidance

The U.S. Equal Employment Opportunity Commission (EEOC) published a technical assistance document, "Discrimination Against American Workers Is Against The Law," explaining how anti-American bias can violate Title VII of the Civil Rights Act of 1964. It provides examples and specifies several potential business rationales that cannot be used to justify national origin discrimination or anti-American bias.

EEOC also updated its national origin discrimination landing page, reflecting the administration's priority focus on anti-American bias. Employers should evaluate policies and practices and address those that favor workers of other national origins or visa statuses over American workers. Training managers to audit for disparate treatment and document neutral, job related criteria for employment decisions is critical to mitigate risk.