The Medicare Secondary Payer Act (MSP) was intended to make Medicare a secondary payer to other insurance, such as workers’ compensation. The MSP specifically indicates that Medicare’s interest must be taken into consideration regarding any workers’ compensation settlement that closes future medical benefits. The essence of the MSP is to prevent the shifting of responsibility for payment of work-related medical services and prescription drug charges from a workers’ compensation provider to Medicare.
To ensure that our clients comply with the frequently changing requirements of MSP, we have a Medicare Department staffed with knowledgeable workers’ compensation professionals with years of experience, as well as registered nurses all overseen by an attorney. Our dedicated team can either coordinate with your designated vendor or handle the entire process from the preparation of the Medicare Set Aside (MSA) through and submission to CMS in house.
In those cases where CMS review is not recommended, we can prepare a Claims Settlement Allocation (CSA) to be included in the settlement agreement to protect Medicare’s interest.
In addition, we offer the following associated services:
- Conditional payment/lien reduction services;
- Legal opinion letters;
- Structured settlements;
- Social Security and Medicare verification;
- Rated age;
- Preparation of Appeals/Requests for Reconsideration of CMS/MSA determinations.
Our Medicare department works closely with the rest of our firm to coordinate swift and cost-effective resolution of claims while appropriately protecting the interests of Medicare as required by the MSP.