LMSA – Liability Medicare Set Aside

Medicare Set Aside and Liability Cases: Is it a Requirement?

Unlike workers’ compensation cases, Centers for Medicare and Medicaid Services (CMS) has issued no formal statutes, regulations, or guidelines concerning liability settlements. However, attorneys and their clients must be certain they are still placing a priority on protecting the interests of Medicare.

LMSA Memorandums Attorneys Should Know About

Following is a brief synopsis of two memos attorneys should familiarize themselves with that address Medicare set asides (MSA) and liability settlements.

The Stalcup Memo:

The memo is from Sally Stalcup, the MSP Regional Coordinator for CMS. Although a MSA is not required by law in liability settlement cases involving a Medicare beneficiary, Medicare’s interests should always be protected. It is expected that if a Medicare beneficiary is awarded in a case, those funds should be used towards medical services and exhausted before Medicare will step in. It is left up to attorneys to decide, per case, if there is future funding for medical services and a need to protect Medicare’s interests.

The CMS HQ Memo:

The memo from CMS Baltimore office states that a LMSA isn’t necessary if the Medicare beneficiary’s physician certifies in writing that all injury-related medical services to the claimed injury have been completed as of the date of the settlement. Any additional treatments made thereafter would need a written certification in the same manner. The physician’s certification would make getting a formal review from the CMS office unnecessary.

The Role of CMS

The CMS regional offices will review LMSAs on a case-by-case basis. Some offices may review them and some may not since there is no mandated law for liability MSA. Regardless of whether a LMSA is reviewed or approved, attorneys and clients must be must be certain that Medicare is always treated as a secondary payer to any other entity responsible for payment of medical items and services related to the liability settlement.

How Synergy Settlement Solutions Helps You

You have helped your client, now let Synergy Settlement Solutions help you. We know that an LMSA can become complicated without proper knowledge. However, we understand the complexities of Medicare laws and how they affect Medicare beneficiaries. To make your job easier, we offer an array of services including MSA analysis, allocation, and administration. Regardless of whether CMS reviews a liability MSA or not, we want you to be confident that your client maintains their Medicare eligibility and that you both remain Medicare compliant.

For more information or to schedule a consultation, please submit our contact request form or call (877) 242-0022.

Disclaimer: The information contained in this article is for general educational information only. This information does not constitute legal advice, is not intended to constitute legal advice, nor should it be relied upon as legal advice for your specific factual pattern or situation.

TESTIMONIALS

"In my business as a plaintiff’s products liability lawyer, everything begins and ends with our clients. In our firm we never handle a significant case without the assistance of Synergy. Why? Very simple: we trust Synergy with our clients. Yes, Synergy only works with plaintiffs. And yes, they are highly technically proficient and know this business cold. But what makes them different from others is that they listen to our clients, make our clients comfortable with complex issues, and always put the interests of the client first. In my opinion, because of their unique ability to handle people with sincerity and compassion in their time of crisis, they stand head and shoulders above his competition."

Richard Newsome
Newsome Law Firm, Past President of Florida Justice Association

"Whenever I have turned to Synergy, their team has always been there for our firm and our clients. They always take the time to answer all our clients’ questions and provide quick, accurate and reliable information so they can make an informed decision regarding structured settlements. With Synergy on our side, we know that our clients are getting the best service and the best structured settlements."

Troy Rafferty
Levin, Papantonio, Thomas, Mitchell, Echsner & Proctor

Ready to schedule a consultation?

The Synergy Settlements team will work diligently to ensure your case gets the attention it deserves. Contact one of our legal experts and get a professional review of your case today.

Request Consultation
WordPress Image Lightbox