Are Medicare Set-Aside Allocations Changing in 2018? Part 2

If you are a personal injury attorney, you already know that Medicare Set-Aside allocations are precarious territory. Not only can they be complex in and of themselves, but the MSA guidelines change continually. It is imperative to protect yourself professionally and stay ahead of the curve as we enter the new year.

In Part 1 of this two-part article, we covered recent revisions to the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide. In the second half, we will discuss the potential new set-aside process for Liability Medicare Set-Asides (LMSAs) and No-Fault Medicare Set-Asides (NFMSA).

A New Set-Aside Process for LMSAs?

In the past, liability MSAs have represented a “Wild West” of sorts. In contrast to the requirements for Workers’ Compensation Medicare Set-Asides (WCMSAs), which have been at least somewhat well-established for awhile now, LMSAs always represented a gray area.

If you have dealt with liability cases in the past, you’ve probably experienced how complicated it was to close a case without the looming worry that Medicare might seek reimbursement from your client long after everything has seemingly been settled.

Last year, both the legal and insurance communities prepared themselves for change after Medicare announced that on October 1, 2017, it would go live with new guidance regarding LMSAs and NFMSAs. However, on October 3rd, Medicare rescinded its announcement that new guidelines would be released.

The relevant page of the Medicare website, last modified on December 18, 2017, reads:

“The Centers for Medicare and Medicaid Services (CMS) continues to consider expanding its voluntary Medicare Set-Aside Arrangements (MSA) review process to include liability insurance (including self-insurance) and no-fault insurance MSA amounts. CMS will work closely with the stakeholder community to identify how best to implement this potential expansion of voluntary MSA reviews. Please continue to monitor this website for updates and announcements of town hall meetings in the near future.”

How It Affects You and Your Client

Since the anxiously anticipated update has been put on hold, you might be wondering where this leaves you and your clients.

As Medicare advises on its site, staying tuned on the potential new guidance is a good idea. In the meanwhile, the gray area surrounding LMSAs and NFMSAs remains gray.
To ensure your clients’ MSAs are handled correctly without taking too much time out of your schedule, it can help to outsource the work to an expert.

For more information or to schedule a consultation, please submit our contact request form or call (877) 242-0022.

Disclaimer: The information contained in this article is for general educational information only. This information does not constitute legal advice, is not intended to constitute legal advice, nor should it be relied upon as legal advice for your specific factual pattern or situation.

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Understanding Structured Settlements and Medicare Set-AsidesThird Thursday Webinar Series

The parties agree that a Medicare Set-Aside is needed, now what? In this month's webinar, presented by Synergy CEO, Jason D. Lazarus, you will learn about the process basics for setting up a set aside including MSA allocations, funding mechanisms for set-asides, post-settlement administration as well as an overview of the process to make sure you close the case compliantly.

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