Obtaining Optimal Outcomes in Medicare Set-Asides: A Legal Perspective
Jesse Hamby
April 8, 2016

Workers’ Compensation Medicare Set-Asides (WCMSAs) are a recommended tool by the Centers for Medicare and Medicaid Services (CMS) to evidence the protection of Medicare’s interests for workers’ compensation settlements. A fully accepted claim with undisputed treatment/injuries is rather simple from a submission and CMS review standpoint. However, where an Employer/Carrier has disputed or limited specific treatment or injuries based upon a state workers’ compensation law or a court order, WCMSAs can become more complex should the parties wish to submit the WCMSA and have CMS align its WCMSA determination in accordance with that state law/court order to effectively obtain a reduced allocation.

Read Heather Sanderson’s Full Article in Claims Management Magazine (Page 20)