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CMS Enforcement Of MSP Regulations: You’re In Charge!

As of October 1, 2017, CMS has begun enforcement of existing regulations requiring MSA for liability settlements. In the first few days after implementation it became clear that most attorneys felt unprepared and unsure about how to comply with the new requirements. LMSA Consulting deals with hundreds of lawyers, of which more than 80% were without a plan or even the understanding to formulate a plan.

At LMSA Consulting we know this much: It’s much simpler than you think and we have a solution.

Some facts: CMS has begun ramping up MSP enforcement procedures for liability cases beginning this month. While CMS has not provided additional guidelines for practical compliance, we do know this:

  1. MSP impacts clients already on Medicare (for any reason)
  2. MSP impacts clients who will be on Medicare within 30 months, typically due to age (62.5 or more) and eligibility for Social Security Disability benefits
  3. If no future injury related medical care is anticipated, a physician statement is required
  4. Some type of future medical cost projection can be used to apportion the settlement; if no cost projection prepared, CMS will want the whole settlement amount spent on future treatment prior to their payments.
  5. The future medical cost projection can be in a variety of formats and called by different names: post-settlement allocation, future medical cost projection, Medicare Set-Aside
  6. Unlike the process for Worker’s Compensation cases, liability compliance does not currently have a review process established and there is no requirement for a separate, interest bearing account or annual reporting. This may change.
  7. Plaintiff Attorneys are subject to penalties, both legal and professional, if these provisions are not complied with.

Creating a liability MSA involves a very different approach and strategy than the MSA prepared for Worker’s Compensation cases. It is imperative for the plaintiff attorney to know how to handle these case situations: CMS has outlined penalties and fines, and clients expect competent representation for pre-and post-settlement concerns.

LMSA Consulting Services can help you with post-settlement allocations for liability cases and other types of future medical cost projections for both Worker’s Compensation and Personal Injury cases.

We have developed and are using proprietary forms and algorithms designed specifically for LMSA reporting and approved by attorneys as being CMS compliant.

Protect yourself. Consider an LMSA for all MSP impacted cases.

Call us at 845-797-8547 or email to [email protected]
Bob Rice, President, LMSA Consulting Services, LLC