blackburn group inc.

linked in twitter facebook

Medicare Set Aside Resources and News

Workers Compensation Medicare Set Aside (MSA)

Workers Compensation Medicare Set Aside

Our client asked us to assist them on a case that was originally reserved for $520,000. With our lien verification and negotiations, we were able to reduce the claim reserve to $150,000. The Medicare Set Aside (MSA) amounted to $10,000 and the remainder of the claim settlement amounted to $140,000. We were able to produce a savings of $370,000, or 71%, from the original offer and potential future Permanent Partial Disability (PPD) lifetime benefits that would have been paid if the claim never settled.

Workers Compensation Medical Cost Projection

Workers Compensation Medical Cost Projection

In a recent case, our review indicated that the case would have cost another 30 years of lifetime benefits, or over $624,000. With our Settlement Solutions including the Medical Cost Projection of $12,000, the final settlement amounted to $147,000. This was a savings of $477,000, or 76%, from the original offer and potential future Permanent Partial Disability (PPD) lifetime benefits that would have been paid if the claim never settled.

Auto Liability Medicare Set Aside (MSA)

Auto Liability Medicare Set Aside

We were asked by our client's attorneys to assist them in a case involving a very substantial liability claim settlement. We produced a favorable Medicare Set Aside, and the client is now able to manage their assets and account for their MSA with our assistance. The client and their family have been relieved that they will be able to preserve their eligibility with Medicare when the MSA funds have been exhausted.

Latest Medicare Set Aside (MSA) News

The Centers for Medicare and Medicaid Services (CMS) Announce a New MSA Reference Guide

CMS Announced recently that a new Workers' Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide has been posted on their website. For a copy of the full user guide, please click here.

For more information about the entire MMSEA Medicare Secondary Payer (MSP) Non-Group Health Plan (NGHP) User guidance from CMS, please click here.

CMS Is Improving Turnaround with Workers’ Compensation (WCMSA) and Liability (LMSA) Medicare Set Asides

Our review of the Centers for Medicare and Medicaid Services (CMS) process has determined that CMS's Worker's Compensation Review Contractor (WCRC) continues to improve its turnaround times. Liability case (LMSAs) approvals are about the same time frame as earlier this year. The approval process is managed directly with the designated CMS Regional Office (RO).

The Approval times on both Workers’ Compensation and Liability cases remains around 30-45 days, assuming there is no requests by either the Worker’s Compensation Review Contractor (WCRC) or the CMS Regional Office (RO) for additional information from the claimant. At the present time there does not appear to be any significant backlog and the review contractor and CMS appear to remain on track in concentrating on new submissions.

Interesting Statistics from CMS Fast Facts.

Additional Breaking Medicare News.

supported by:

Blackburn Group, Inc.   RiskPro® is a registered trademark of Blackburn Group, Inc.