Should a Plaintiff Self-Administer an MSA?

After settling a case for a Medicare beneficiary client, the next task will be administering their Medicare Set Aside (MSA) account. Your client may choose to self-administer their MSA, which is perfectly legal because The Centers for Medicare and Medicaid Services’ (CMS) guidelines allow for self-administration or professional administration. The guidelines are the same regardless of how MSAs are administered, with the exception of some minor reporting and accounting. Although the process can be daunting and a potentially huge liability, many of your clients may choose to go this route.

Challenges for the Client

Self-administration is not a simple undertaking. Your client must understand both the financial and medical administrative requirements to navigate the process successfully. Your client must ensure that the set aside pays the appropriate calculated rate, funds are spent on Medicare expenses and documented appropriately, and injury-related care is not paid for by Medicare until those set-aside funds have been exhausted. If your client does not properly administer their MSA, they could run out of money faster than expected or Medicare may end up denying coverage for their medical benefits.

Assisting Your Client

The loss of your client’s future Medicare benefits is at stake if they are not equipped to successfully self-administer their MSA. As their attorney, you can assist them by educating them on the intricacies of MSAs and self-administration, and provide them with the appropriate tools and resources to increase their chance of success. Additionally, you should evaluate your client to determine if they have the capacity to carry out self-administration. Assess whether they are mentally and physically capable of managing payments and complying with CMS requirements.

Professional Administration is Preferred

If you find that your client is ill-equipped to undertake self-administration, especially one involves multiple lien holders, recommend professional administration. This method is preferred because the assigned trustee has a fiduciary duty and the professional administrator will understand the intricacies of managing MSA funds and reporting them to CMS.

At Synergy Settlement Solutions, our MSA program employs a Medicare Set Aside Trust arrangement. We have extensive experience assisting attorneys and their clients with MSA and settlement needs including Medicare set aside allocations, submissions, and analysis.

For more information or to schedule a consultation, please submit our contact request form.

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

"Coincidentally, on the day of a recent Synergy Seminar on Medicare & ERISA lien resolution I received a letter on an ERISA lien. This letter followed much back and forth between myself and the recovery vendor for BCBS. Despite my efforts they were adamant there would be no (zero)(zilch)(nada) reduction and provided case law to support their position. I tried Synergy’s Lien Resolution Services since I had just heard their Director of Lien Resolution speak. Synergy got them to reduce their claim by a third in less than ten (10) days. The result was quick and the fee very reasonable. If you have a tough ERISA lien and your typical efforts don’t work, give Synergy a try."

Michael S. Smith, Esq.
Lesser, Lesser, Landy & Smith, PLLC

WordPress Image Lightbox