Medicare Secondary Payer Act Compliance
Handling Medicare Issues for Workers’ Comp and Personal Injury Clients
To settle a workers’ compensation or personal injury claim in which the settlement seeks to cover future medical expenses, it’s often necessary to create a Medicare set-aside (MSA) arrangement or otherwise demonstrate that Medicare’s interests have been protected in compliance with the Medicare Secondary Payer Act. Just as important, but often overlooked, is the need to investigate, negotiate, and resolve Medicare conditional payments.
At Weld Riley, our experienced attorneys assist clients with Medicare Secondary Payer Act compliance. Unlike many workers’ compensation and personal injury firms, we negotiate conditional payments and submit MSA proposals in-house, simplifying the settlement process.
Attorney Melissa A. Kirschner is a member of the National Alliance of Medicare Set-Aside Professionals (NAMSAP), a non-profit association addressing the issues and challenges of the Medicare Secondary Payer Act statute and its impact on workers’ compensation and liability settlements.
Ms. Kirschner is also Medicare set-aside consultant certified (MSCC), a credential designated by the International Commission on Health Care Certification to identify professionals with specific pre-approved training in Medicare set-aside arrangements and who possess a breadth of knowledge in the Medicare set-aside arrangement process.
Understanding When Medicare Set-Aside Arrangements Are Necessary
Not every workers’ comp or personal injury settlement requires an MSA. Our attorneys stay informed of the regulations issued by the Centers for Medicare and Medicaid Services (CMS) and advise our clients on when MSA arrangements are necessary or recommended. This ensures that settlement funds covering future medical expenses are actually used for that purpose before Medicare is billed.
Our lawyers have extensive experience guiding clients toward Medicare solutions for specific circumstances. In addition, our attorneys offer innovative strategies for dealing with claims that do not meet the CMS review thresholds.