VoCare Services Medicare Set-Aside Arrangement (MSA) experts provide needed services in the event that a workers’ compensation catastrophic injury requires future financial consideration and the claimant is entitled to Medicare benefits.
In 2001, the Centers for Medicare and Medicaid Services (CMS) issued guidelines regarding workers’ compensation and the settlement of workers’ comp claims. Since Medicare is a secondary payor to Workers’ Compensation, CMS issued policies that require it be notified so that it can set up a claim tracking system to prevent Medicare from making mistaken payments.
When it is time to reach a lump sum settlement of a workers’ comp matter, this interest may need to be reflected in a Medicare Set-Aside Arrangement if:
- A claimant is currently entitled to Medicare, regardless of the settlement amount; or
- The settlement amount is equal to or greater than $250,000 and the claimant can reasonably be expected to be eligible for Medicare within 30 months of the settlement.
The consequences of failing to make provisions for Medicare Set-Aside requirements when settling a workers’ compensation claim can be severe.
The Centers for Medicare Services can sue to recover $1000 per claim per day for non-compliance up to double damages.
Claimants are also at risk for losing their Medicare coverage.
VoCare Services’ experts in workers’ compensation and catastrophic injury, provide clients with medical settlement costs, planning, and compliance procedures to stay aligned with all CMS guidelines and requirements and protect Medicare’s interests as a secondary payor to other available insurance plans. For further information about our Medicare Set-Aside Arrangement services, contact us.