Synergy Blog

Medicare Set Asides – Regulations Coming for Liability Settlements, CMS Issues Notice of Proposed Rulemaking

By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC

It appears Medicare is poised to begin the rulemaking process for Medicare Set Asides by issuing a notice for proposed rulemaking as early as September of this year.  As most of you know (from my previous blog posts – to view click HERE), last year they issued an Advanced Notice of Proposed Rulemaking.  This was the first step in the regulatory process.  They solicited commentary from the legal community and industry stakeholders.  I was on AAJ’s committee that provided commentary.  I also drafted commentary of my own on behalf of Synergy.  I hope that CMS considers all of the commentary when crafting rules for set asides as if they don’t get this right, it could cause huge problems in the resolution of cases involving Medicare beneficiaries.  The target date for the “NPRM” is 9/13, so we will know shortly if they gave any consideration to the viewpoints offered.  The NPRM is most likely will address how to set aside properly to comply with CMS’s interpretation of the Medicare Secondary Payer Act. 

A Medicare Set Aside is a mechanism created by CMS to avoid shifting the burden from a defendant/insurer to Medicare for injury related care when future medicals are funded as part of a settlement, judgment or award.  With a set aside, an “allocation” is created to determine the amount of money for future Medicare covered services.  That amount is then “set aside” and spent on injury related care until exhausted.  Once exhausted, Medicare picks up the remaining tab.

To view information on the proposed rulemaking, click HERE

Ready to schedule a consultation?

The Synergy Settlements team will work diligently to ensure your case gets the attention it deserves. Contact one of our legal experts and get a professional review of your case today.

Request Consultation

TESTIMONIALS

“Synergy is our guiding light for deferring our contingent legal fees and planning for retirement. The lawyers at Panter Panter & Sampedro, myself included, have been working with them for over ten years using different methods to defer comp and plan for retirement.”

Brett Panter
Panter, Panter & Sampedro

"I don't think I've directly said "thank you" for helping us with Bridgett’s case. We sent the reduced payment to Medicaid and called Bridgett's mom to tell her approximately how much money was going to be left for Bridgett and she broke down over the telephone. Given only $25k of insurance and a $850k medical bill from the hospital she didn't think Bridgett would ever see a penny."

Tom L. Copeland
Jeffrey Meldon & Associates, P.A.

WordPress Image Lightbox

Get access to the Synergy Workers' Compensation Learning Center

Subscribe
Liability MSAs: Is It Time To Worry? Third Thursday Webinar

Join us this month for a special presentation by Synergy's Vice President, Medicare Secondary Payer Compliance, B. Josh Pettingill, to discuss the Centers for Medicare and Medicaid Services' (CMS) potential regulations on Liability MSAs and best practices for protecting your law firm as it relates to MSP compliance, including Medicare Advantage. A 15-minute question and answer session will follow.