User Agreement

Title Line



1. Purpose of Workers' Compensation Medicare Set-Aside Portal (WCMSAP) Secure Web site

The Workers' Compensation Medicare Set-Aside Portal (WCMSAP) will allow for the electronic receipt/processing of workers' compensation Medicare Set-Aside arrangement (WCMSA) proposals for future medical and future prescription drug costs. With the introduction of a WCMSAP web portal, WCMSA submitters will receive prompt and direct feedback regarding a WCMSA case.

Additionally, this application will also provide a means for WCMSA submitters to review the status of current WCMSA submissions and statistical information related to historical submissions.

2. Privacy Act Statement/ Systems of Record/ Disclosure Policy

The U.S. Department of Health and Human Services (HHS) at (, of which the CMS COB Secure Web site is a part, has a clear privacy policy. When you access the COB Secure Web site, we collect the minimum amount of information about you necessary to manage your account. The authority for CMS to collect this information is Section 1862(b)(2) of the Social Security Act. The CMS will utilize the information collected to 1) make a determination concerning whether a submitter's WCMSA proposal adequately protects Medicare's interests and 2) update our internal systems of record to ensure that Medicare makes no payment in connection with health services resulting from a work-related illness, inquiry, or disease until WCMSA funds have been appropriately exhausted.

Information originally collected in traditional paper systems can be submitted electronically, i.e., electronic commerce transactions and information updates about eligibility benefits. Electronically submitted information is maintained and destroyed pursuant to the Federal Records Act and in some cases may be subject to the Privacy Act. The information collected through the WCMSAP will be stored within the following CMS Privacy Act systems of records , as appropriate: Workers' Compensations Set-Aside File (09-70-0537) and the Common Working File (09-70-0526). [These systems of records may be referenced by accessing the following:    and

The basic insurance data created internally to ensure that Medicare only makes primary claim payment when appropriate may be disclosed only as permitted by the routine use disclosure provisions outlined for each of the above systems of record. The HHS and CMS do not disclose, give, sell, or transfer any personal information about its visitors, unless required for law enforcement or statute.

3. Information Automatically Collected and Stored

When you browse through any Web site, certain personal information about you can be collected. We automatically collect and temporarily store the following information about your visit:

  • the name of the domain you use to access the Internet (for example,, if you are using an American Online account, or, if you are connecting from Stanford University's domain);
  • the date and time of your visit;
  • the pages you visited; and
  • the address of the Web site you came from when you came to visit.

This information is used for statistical purposes only and to help us make this site more useful to visitors. Unless it is specifically stated otherwise, no additional information will be collected about you.

4. Information Collected through the COB Secure Web site

To ensure that your personal information is securely and safely transmitted, the personal information you provide is encrypted and sent to us using a secure method. However, no one can give an absolute assurance that information intended to be maintained as private, whether transmitted via the Internet or otherwise, cannot be accessed inappropriately or unlawfully by third parties. We have taken, and will continue to take, reasonable steps to ensure the secure and safe transmission of your personal information.

5. Personally Provided Information

If you are not responsible for the submission of WCMSAs using the COB Secure Web Site, you do not have to give us personal information. If you choose to provide us with additional information about yourself through E-mail, forms, surveys, etc., we will maintain the information as long as needed to respond to your question or to fulfill the stated purpose of the communication.

6. Intrusion Detection

The U.S. Government maintains the Web site. It is protected by various provisions of Section 1862(b) of the Social Security Act (42 U.S.C. Section 1395y(b)(5)), Publication 1075 of the Department of Treasury, Internal Revenue Service, and Title 18 of the U.S. Code. Violations of Title 18 are subject to criminal prosecution in Federal court.

For site security purposes and to ensure that this service remains available to all Users, we employ software programs to monitor traffic to identify unauthorized attempts to upload or change information, or otherwise cause damage. In the event of authorized law enforcement investigations, and pursuant to any required legal process, information from these sources may be used to help identify an individual.

7. Links

References from this Web site to any non-governmental entity, product, service or information do not imply endorsement or recommendation by CMS, HHS or any other HHS agency or employees

We are not responsible for the contents of any "off-site" Web pages referenced from this server. We do not endorse ANY specific products or services provided by public or private organizations. In addition, we do not endorse the views expressed by such sites, nor do we warrant the validity of any site's information or its fitness for any particular purpose.

8. Pop-up Advertisements

When visiting our Web site, your web browser may produce pop-up advertisements. These advertisements were most likely produced by other web sites you visited or by third party software installed on your computer. The CMS does not endorse or recommend products or services for which you may view a pop-up advertisement on your computer screen while visiting our Web site.

9. Out-dated Information

Many HHS/CMS documents are time sensitive. Department policies change over time. Information in older documents may be out-dated. You also may wish to review our Privacy Policy, above.

10. Accessibility

This page provides information for those visitors who use assistive or other devices to access the content on this Web site. Please see our Contact section at if you have general questions and comments or have difficulty finding something on this Web site.

11. Synopsis of Section 508 Accessibility Requirements

Section 508 requires that individuals with disabilities, who are members of the public seeking information or services from this Web site have access to and use of information and data that is comparable to that provided to the public who are not individuals with disabilities, unless an undue burden would be imposed on us. Section 508 also requires us to ensure that Federal employees with disabilities have access to and use of information and data that is comparable to the access to and use of information and data by Federal employees who are not individuals with disabilities, unless an undue burden would be imposed on us. To learn more about the regulations governing the accessibility of Federal electronic information, you can reference the Synopsis of Section 508 Accessibility Requirements at

The CMS COB Secure Web site is a service of the U.S. Department of Health and Human Services at Any Freedom of Information Act (FOIA) requests concerning this Web site should be submitted in accordance with the Department's FOIA guidelines, which are online at Information on making FOIA requests is available at the Freedom of Information Group page. You also may wish to review our Privacy Policy above.


The submitter agrees to establish and implement proper safeguards against unauthorized use and disclosure of the data for the purposes of WCMSA proposal(s) review and processing. Proper safeguards shall include the adoption of policies and procedures to ensure that the data obtained shall be used solely in accordance with Section 1106 of the Social Security Act [42 U.S.C. § 1306], Section 1874(b) of the Social Security Act [42 U.S.C. § 1395k(b)], Section 1862(b) of the Social Security Act [42 U.S.C. § 1395y(b)], and the Privacy Act of 1974, as amended [5 U.S.C. § 552a]. The WCMSA submitter shall establish appropriate administrative, technical, procedural, and physical safeguards to protect the confidentiality of the data and to prevent unauthorized access to the data provided by the CMS. You agree that the authorized representatives of the CMS shall be granted access to premises where the Medicare data are kept for the purpose of inspecting security arrangements and confirming whether the WCMSA submitter is in compliance with the security requirements specified above. Access to any records created by the WCMSA process shall be restricted to authorized CMS and WCMSA submitter employees, agents and officials who require access to 1) perform their official duties in accordance with the approved uses of the information; (2) respond to authorized for law enforcement investigations; or (3) respond to any required legal process. Such personnel shall be advised of (1) the confidential nature of the information; (2) safeguards required to protect the information; and (3) the administrative, civil and criminal penalties for noncompliance contained in applicable Federal laws.


The submitter acknowledges that criminal penalties under section 1106(a) of the Social Security Act [42 U.S.C. § 1306 (a)], including possible imprisonment, may apply with respect to any disclosure of data received from the CMS that is inconsistent with the purposes and terms of the Agreement. The submitter further acknowledges that criminal penalties under the Privacy Act [5 U.S.C. § 552a(i)(3)] may apply if it is determined that the submitter, or any individual employed or affiliated therewith, knowingly and willfully obtained the data under false pretenses.