medicare compliance

A Medicare Set-Aside or "MSA", is an estimate of future Medicare-eligible costs that is a legally required portion of some workers' compensation settlements. The MSA process is also becoming a more common practice within the liability space of the industry as well.

MSA regulations are supported by the Medicare Secondary Payer Act ("MSP act"), which has been in effect since 1980. The MSP Act dictates what collection authority Medicare has when a settlement involving a Medicare beneficiary occurs and why settlement funds that are set aside for treatment must be used as the primary fund for treatment, before Medicare will step in as the primary payer. In 2001, the Centers for Medicare & Medicaid Services ("CMS") began to enforce the Medicare Secondary Payer Act.

In early 2000, a study revealed that between 1991-1998, the Federal government paid approximately $40 billion for medical care, where Medicare should have been the secondary payer. In July 2001, CMS issued a memorandum requiring worker's compensation settlements to establish MSA accounts funded with money awarded to claimants for Medicare-eligible expenses. The management of set-aside funds, and reporting to Medicare can be an extremely complex and cumbersome process.

Our expert team has helped thousands of injured individuals navigate through the intricacies of Medicare's guidelines in order to keep their benefits protected. We do this all while offering substantial discounts for services, and providing a completed annual report for your review and submission to Medicare.