Tag Archives: MSA

Liability Medicare Set-Asides: Where are we Today?

November 12, 2020 By: Rasa Fumagalli, JD, MSCC, CMSP-F The Centers for Medicare and Medicaid Services (CMS) has been slow in providing detailed guidance in the area of liability settlements that include compensation for future medicals. To date, the guidance consists of the May 2011 CMS Stalcup memo and the September 2011 CMS memo regarding…

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The Unregulated New Frontier of Medicare Set-Asides

September 29, 2020 Excerpt from The Art of Settlement Consider this scenario: you represent a current Medicare beneficiary in a third-party liability case. As part of the workup of the case, you determine the client will need future medical care related to the injuries suffered, and you settle the case. Since the client is a…

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Liability Medicare Set-Asides (LMSAs): Insurance Policy for All

March 12, 2020 B. Josh Pettingill This article highlights why a Medicare Set-Aside (MSA) should be viewed by all settlement parties as an insurance policy – nothing more, nothing less. Medicare Secondary Payer Compliance is not a scare tactic, nor is it something to be disregarded. Rather, addressing the MSP by analyzing the need for…

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Liability Medicare Set-Asides (LMSAs): Is It Time to Start Worrying?

B. Josh Pettingill For over a decade, there has been episodic activity from Centers for Medicare and Medicaid Services (CMS) on Liability Medicare Set-Asides (LMSAs), including but not limited to, policy memorandums, Medicare Learning Network announcements, a notice of proposed rulemaking with subsequent withdrawal, an advanced notice of a notice of proposed rulemaking as well…

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Medicare Set-Aside Self-Administration: What is new?

B. Josh Pettingill Last week, the Centers for Medicare and Medicaid Services (CMS) issued the latest edition of their Medicare Set-Aside (MSA) self-administration toolkit. This toolkit is intended to serve as a guidebook or roadmap for how to properly administer a Workers’ Compensation Medicare Set-Aside (WCMSA) account. The statistics show that 99% of claimants elect…

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Evidence Based MSAs (EBMAs): Don’t Accept Blindly

B Josh Pettingill Evidence Based MSAs (EBMSAs) have taken the workers’ compensation industry by storm the past several years. It is imperative for workers’ compensation attorneys to understand how EBMSAs can impact both the settlement value, as well as your clients’ benefits post-resolution. EBMSAs can be a cost savings mechanism in resolving a workers’ compensation…

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Liability Medicare Set-Aside (MSA) Case Studies: Eliminate, Reduce & Comply

B. Josh Pettingill There is mounting evidence that the Centers for Medicare and Medicaid Services (CMS) will establish formal guidelines for liability MSAs in the imminent future.  Medicare Secondary Payor compliance related to future medical care is an issue that can’t be ignored but that doesn’t necessarily mean setting up a Medicare Set-Aside on every…

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Taking Advantage of the WCMSA Re-Review Process

B. Josh Pettingill We frequently receive inquiries regarding workers compensation MSAs (WCMSAs) and whether it is possible to get CMS (Centers for Medicare and Medicaid Services) to re-review an MSA once an amount has already been approved. The good news is that it is possible. However, you only get one opportunity and certain criteria must…

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