Our Medicare Compliance Practice Group was formed to assist insurers, self-insureds, third-party administrators, plaintiff attorneys and defense attorneys.

Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) allocates a portion of the workers’ compensation settlement for all future work-injury-related medical expenses that are covered and otherwise reimbursable by Medicare.

This document is a financial agreement that allocates a portion of a workers’ compensation settlement to pay for future medical services related to the workers’ compensation injury, illness, or disease. These funds must be depleted before Medicare will pay for treatment related to the workers’ compensation injury, illness, or disease.

All parties in a workers’ compensation case have significant responsibilities under the Medicare Secondary Payer Act to protect Medicare’s interests when resolving cases that include future medical expenses.

Our attorneys provide assistance in meeting these obligations in the following ways:

– Medicare set aside preparation and submission.

– Settlement document preparation.

– Future medical cost projections.

– Medicare beneficiary status determination and analysis.

– Guidance regarding conditional payment liens.

One of our lawyers in the Medicare Compliance Practice Group regularly speaks at seminars for attorneys and insurance professionals on issues involving Medicare Secondary Payer Act compliance and the necessity of Medicare Set-Aside Accounts in workers’ compensation and liability cases.

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