On 3/15/22, Medicare amended the language from their January 2022 Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide saying they may deny payment for medical services that are not properly documented and managed.
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During the past several months, our clients have asked us to revisit the key criteria for The Centers for Medicare and Medicaid Services (CMS) determining if a Lump Sum or Structured Settlement sufficiently takes into account it’s interests for a Medicare Set Aside (MSA).
Risk Managers, Claim Managers, Adjusters and Attorneys are all obligated to inform the injured Medicare Beneficiary about consideration of MSP rules and compliance during the claim settlement process. What are the key considerations for these obligations in the discovery process?