Medicare Set-Asides

Medicare Set-Asides

The Medicare Secondary Payer Act (MSP) demands and ensures that Medicare's interest be taken into consideration where the settlement funds include payment for future medical care. With the addition of the MSP provisions in 1980, Medicare is secondary payer to group health plan insurance in specific circumstances, but is also secondary to liability insurance (including self-insurance), no-fault insurance, and  WC. If Medicare's interest is not protected, they can take legal action to recover funds and Medicare benefits can be negatively impacted in the future.

In certain cases, Medicare strongly recommends that future related Medicare allowable medical care be set-aside from the settlement monies and Medicare will review/approve the adequacy of the amount, hence the Medicare Set-Aside Allocation (MSA). As the representing attorney, it is imperative that you understand when and how the case should be evaluated to assure Medicare's interest has been taken into consideration..

An MSA is a detailed report which determines future medical care and what is acceptable/covered by Medicare. Our nurses are able to provide a detailed review and allocation for future medical care when an allocation of settlement monies is prompted.

Includes:

  • Detailed summary of medical records involving injury.

  • Spreadsheet of Medicare covered expenses for future medical care and medications.

  • Allocation of monies for future medical expenses.

  • Spreadsheet of Non-covered Medicare expenses for future medical care and medications.

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