Medicare Set-Aside reporting services

Seller Financing Available

Founded in 1995, this firm assists counsel, insurance carriers, self-insured employers, and third party administrators in settling workers’ compensation and liability claims while preserving the claimant’s Medicare eligibility. We communicate closely with the Workers’ Compensation and Liability attorneys as well as the Self Insured or Insurance Carrier to ensure compliance with Medicare’s statutes and regulations. Our courteous and knowledgeable staff are accessible and eager to provide prompt answers to your questions.

When settling claims, parties must consider Medicare’s interests under the Medicare Secondary Payer (MSP) Act. Medicare’s preferred method of compliance is for the settlement to include funding of a Medicare Set-Aside (MSA). This involves setting aside a portion of the settlement funds to cover injury related medical care that would otherwise be covered by Medicare. If the Centers for Medicare & Medicaid Services (CMS) determine the set-aside amount is adequate, Medicare will agree to primary payer status once the MSA funds are exhausted.

To ensure any subrogation interests held by Medicare are satisfied pursuant to the MSP Act and regulations, Medicare recovery claims must also be resolved. Our firm conducts conditional payment research to determine whether CMS intends to pursue recovery and to identify the conditional payment amounts. Our attorneys offer legal services to reach compromise or waiver of those conditional payment amounts, while preserving the claimant’s Medicare benefits.

We offer a wide range of national case management services. Our case managers work directly with the injured worker, physician or medical provider, employer, adjuster and attorney to provide quality services. All of our case managers follow strict guidelines to help the claimant to get MMI and return to work as soon as possible. Our case managers are experienced in handling acute and long-term clients.