MSP Compliance Solutions

We have been receiving a lot of questions on how to deal with "Zero" Medicare Set-asides. Here are some quick thoughts. 1. The use of an MSA is never required, but determine if one is recommended. Consider Medicare’s interests in all settlements; 2. Review CMS guidance in the WCMSA Reference Guide regarding the reasonableness of any MSA; 3. Consult with a Medicare compliance service provider regarding any allocation amount, including $0 allocations. 4. Include language in your settlement agreement that outlines the justification and reasonableness of a legal or medical $0. We are here to help - look forward to helping you navigate the Medicare maze.

One could argue the WCMSA review and approval process is an unnecessary redundancy now that CMS will actively issue civil monetary penalties on claims involving Medicare beneficiaries that are not properly reported. Is now the right time to end the voluntary review and approval process? Discuss.

CMS continues to roll out significant changes to the voluntary WCMSA review and approval process. Starting in early April, parties will no longer be requires to stand in line to use the Amended Review process. #MedicareSetAsides #WCMSA #Medicare https://lnkd.in/eNEax_5C

CMS announced they will no longer review $0 MSA allocations in workers' compensation settlements. While the change does not take effect until July 17, now is the time to review your compliance programs to avoid missed opportunities. #MedicareSecondaryPayer #CMS https://lnkd.in/gSJSeRMw

The last several years has seen an uptick in U.S. Department of Justice lawsuits against attorneys and law firms over failure to correctly resolve conditional payment matters.?A common resolution to these matters is the requirement firms create a Medicare Secondary Payer compliance manual to better instruct attorneys and support staff on all things Medicare Secondary Payer. What best practices do you want to implement in 2025? Now is the time to consider the creation of such manual in to safeguard your practice. #MedicareSecondaryPayer

The last several years has seen an uptick in U.S. Department of Justice lawsuits against attorneys and law firms over failure to correctly resolve conditional payment matters.?A common resolution to these matters is the requirement firms create a Medicare Secondary Payer compliance manual to better instruct attorneys and support staff on all things Medicare Secondary Payer. What best practices do you want to implement in 2025? Now is the time to consider the creation of such manual in to safeguard your practice. #MedicareSecondaryPayer

The other day, I talked to an attorney who does a great job identifying settlements where a Medicare Set-aside (MSA) is recommended, but never includes information about it.?Makes no sense!?Every settlement that includes an MSA should include information about it.?This should include: 1. The MSA amount 2. The MSA funding mechanism 3. Administration of the MSA 4. A description of the responsibilities of the parties 5. A Reversionary clause 6. Statement of reasonableness Are you including this information in all your settlements that include an MSA? #MSPsmarter https://lnkd.in/eCQ-CMsp

Save the date and register now: Medicare Secondary Payer Update: Section 111 Reporting Impacts All Work Comp Settlements 2024 The Centers for Medicare & Medicaid Services (CMS) announced unexpected and significant changes to reporting requirements that have major implications for worker’s compensation law. CMS will now collect Medicare Set-Aside (MSA) data for all worker’s comp settlements reported via Section 111 of the Medicare, Medicaid, and SCHIP Extension Act (MMSEA) of 2007. These changes have led to confusion in the worker’s comp community about what is required to settle cases. https://lnkd.in/eaMAsCSW

Happy 59th birthday, Medicare! Trivia Question: The first two Medicare beneficiaries are in this picture. Who where they?