Medicare Set-Asides

WCMSA: We prepare unique medial care analysis customized per claim for medically necessary and reasonable allocations. Our services include initial MSA consultative assessment, and comparative future medical care/ pharmacy cost analysis.

Informal MSA: While MSA’s that do not meet the Class I or Class II  threshold are not formally reviewed, it remains true that Medicare beneficiaries still must consider Medicare’s interest in all WC cases. An Informal MSA ensures Medicare’s interests are taken into account and may be used for settlement purposes.

Zero MSA: For claims that have been denied, an analysis is prepared outlining the medical, legal and factual defenses for the denied claim(s).

Attorney Work Product: When there is a possibility of different avenues of future medical treatment, a customized analysis is done to illustrate different WCMSA options.

Liability MSA (LMSA): According to CMS, “”[u]nder the Medicare Secondary Payer provisions, Medicare is always secondary to workers’ compensation and other insurance such as no-fault and liability insurance.” While there are no set guidelines or formal review process, if the Claimant is Medicare entitled a LMSA takes Medicare’s interest into account and may be used for settlement purposes.