CASE REVIEW

• Social Security and Medicare Status Determination
• Determining if case meets CMS / MSA review threshold
• Determining if case requires inclusion and/or submission of MSA

MSA ALLOCATION

• Report Claim to Coordinator of Benefits Contractor (COBC)
• Request for Medicare Conditional Payment Information, if applicable
• Preparation of Medicare Set-Aside Allocation (MSA) & Medical Costs
• Projections to determine future Medicare allowable medical services
• Preparation of Prescription Drug Cost Analysis per Medicare Part D and CMS
• Rated Age Projections
• Experts in structuring Liability MSA's
• Educate and Protect the settling parties ( plantiff atty. & insurance co.) from future Post Settlement Risk.
• Legal Consultation to Address Pertinent MSA Threshold Issues and Other Legal
• Considerations to assure Proper Compliance under the Medicare Secondary Payer Statute.

GENERAL (Medicare Allocation determination for non-catastropic, non-complex cases)
COMPLEX ( Catastrophic and complex injuries i.e. Traumatic Brain Injury, Spinal Cord Injury, Burns, Long-term Claims History with Multiple Injuries or Concurrent Injuries)

MSA $0 ALLOCATIONS

• Determination if $0 Allocation is appropriate
• Prepare $0 Allocation for submission to CMS including applicable legal documents

MSA SUBMISSION

• Preparation of formal MSA submission package to CMS prepared by legal counsel to assure proper compliance under the Medicare Secondary Payer Statute
• Legal review of all MSA's prior to submission to CMS
• Timely Post MSA submission follow up & communication with CMS
• Provide regular post MSA submission updates to client

CONDITIONAL PAYMENTS VERIFICATON/NEGOTIATION

• Conditional Payment Verification & Negotiation

SETTLEMENTS

• Legal Consultation services - Workers' Compensation & Liability Cases
• Legal Review of Settlement agreement to assure proper compliance under the Medicare Secondary Payer Statute, including recommendations for inclusion of necessary settlement provisions.
• Request for Medicare Conditional Payment Information, if applicable
• Advise plaintiff on MSA Setup and proper account Utilization (included in fees)

ADDITIONAL SERVICES

• Legal updates regarding changes to the Medicare Secondary Payer Statute and updated CMS Policy Memorandums & Directives
• Medical Cost Projections for cases not meeting the thresholds
• Medical Cost Projections completed for litigation support/reserves
• MSA updates referral assistance for professional administration of MSA upon request.