“Medicare Set Asides (MSA) have proven a significant roadblock for parties who are desirous of settling a workers’ compensation claim,” writes S. Philip Unwin, an attorney in Goldberg Segalla’s Workers’ Compensation Practice Group.
“When a set aside is submitted to the Centers for Medicare and Medicaid Services (CMS) for review, it frequently takes months, sometimes over a year, for a response to be issued. Further, the amount CMS demands necessary to protect its future interest sometimes has little connection with the status of the case, and there is no ability to appeal this determination. This lack of accountability leads to results that force the parties to leave a case open when both sides would be happier with a settlement.”
But change is on the way, Philip writes. In this article, he examines the Medicare Secondary Payer and Workers’ Compensation Settlement Agreement Act of 2013 — proposed legislation that aims to resolve these problems in a manner that works for the claimants, the carriers and employers, the workers’ compensation boards, and even for CMS.