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Medicare Benefits, Medicare Set Asides, and MMSEA Updates

During the past few months, the Centers for Medicare and Medicaid Services (CMS) have provided updates to its Benefits, Medicare Set Asides (MSAs) and MMSEA Section 111 User Manual. Learn more about the most recent information, and how it affects you and your risk and claim management efforts.

Each year the Department of Health and Human Services (HHS) publishes their updated Official U.S. Government Medicare handbook with important information to know. Click here for the new 2017 “Medicare and You” Handbook in English, Spanish, and a variety of formats.

The information contained in the Handbook should be taken into consideration when Medical Cost Projections (MCPs) and Medicare Set Asides (MSAs) are completed. Beneficiaries must preserve their benefits by setting aside a portion of the settlement money in a segregated interest bearing account to pay for future Medicare covered benefits. Once the MSA account is exhausted, with the understanding that the Beneficiary has complied with all requirements under the law, then full Medicare coverage is provided for any Medicare covered healthcare.

Additionally, information and instructions for the Medicare Secondary Payer (MSP) Non-Group Health Plan (NGHP) reporting requirements mandated by Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) (P.L. 110-173) has been updated in the MMSEA Section 111 Medicare Secondary Payer Mandatory Reporting Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers’ Compensation User Guide (NGHP User Guide). The information and related materials may be found at Medicare’s NGHP User Guide MMSEA Section 111 website

Please feel free to contact us with any questions you may have with this material.

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