Do You Need A Workers' Compensation Medicare Set-aside?

It appears this case does not meet the threshold

for CMS review of a Medicare Set-aside.


You may still need to consider and protect Medicare's interests in the settlement, however.  If the total settlement amount is large and the claimant has a reasonable expectation of Medicare entitlement within 30 months, steps should be taken to consider and protect Medicare's interests.  This can be be accomplished by designating a reasonable sum of money to cover future medical expenses in the settlement documentation.  An MSA allocation report may be useful in that regard, however, such report is not necessary in every case.  

© 2020 Carr Allison Medicare Compliance Group

100 Vestavia Parkway

Birmingham, AL 35216

P: 205.949.2949

F: 205.822.2057



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Required statement from the AL State Bar:  No representation is made that the quality of legal services to be performed is greater than the quality of legal services provided by other lawyers.  Any recoveries and testimonials are not an indication of future results. Every case is different, and regardless of what friends, family, or other individuals may say about what a case is worth, each case must be evaluated on its own facts and circumstances as they apply to the law. The valuation of a case depends on the facts, the injuries, the jurisdiction, the venue, the witnesses, the parties, and the testimony, among other factors.  Disclaimer.