CMS Memoranda

Center for Medicare and Medicaid Services Memoranda

All parties in a workers' compensation case have significant responsibilities under the Medicare Secondary Payer (MSP) laws to protect Medicare's interests when resolving workers’ compensation cases that include future medical expenses. The recommended method to protect Medicare's interests is a Medicare set-aside arrangement, which allocates a portion of the workers’ compensation settlement for future medical expenses. The amount of the Medicare set-aside allocation is determined on a case-by-case basis and should be reviewed by the Center for Medicare and Medicaid Services (CMS), when appropriate. Once the CMS approved set-aside amount is exhausted and accurately accounted for, Medicare will agree to pay primary for future Medicare covered expenses related to the workers compensation injury.

Physicians Medical Review is highly experienced in the development of Medicare set-aside allocations. To determine if a Medicare set-aside allocation is necessary to settle your workers’ compensation or liability case, contact Physicians Medical Review.

CMS Memoranda

To obtain thorough Medicare set-aside documentation — or other medical allocation services — contact Physicians Medical Review.

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