Protect Medicare’s Interests in Workers’ Compensation Settlements
Medicare has been secondary payer in workers’ compensation claims since 1980. However, guidelines for protecting Medicare’s interest were issued for the first time in 2001 by the Centers for Medicare and Medicaid Services (CMS). The two most common settlement cases that require CMS approval are:
- The settlement amount, including lost wages, future medical expenses and other expenses, is $25,000 or greater AND the claimant is already a Medicare beneficiary at the time of the settlement.
- The settlement amount, including lost wages, future medical expenses and other expenses, is $250,000 or greater AND the claimant will be a Medicare beneficiary within 30 months.
In 10 reverse offset states, workers’ compensation benefits can be reduced when a claimant also receives Social Security Disability Insurance (SSDI) benefits. You may have a significant, unrealized opportunity to reduce your future liability for claims in the following reverse offset states:
| Colorado |
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New Jersey |
| Florida |
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North Dakota |
| Louisiana |
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Oregon |
| Minnesota |
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Washington |
| Montana |
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Wisconsin |
Enjoy the Benefits of a Turnkey Solution
Workers' compensation claims and benefits are not only extremely difficult to navigate, but are also fraught with risk from fees and costly penalties. Yet, this area still offers unrealized savings potential for many companies.
With our complete and ready-to-use system, Allsup can help you:
- Minimize your exposure by systematically protecting Medicare’s interests for all appropriate claims.
- Avoid paying needless fees for claims that do not meet CMS guidelines.
- Better manage your MSA program with Allsup’s comprehensive tracking and reporting tools.
- Reduce the time devoted by your staff to completing MSAs. Submit your proposals to CMS within 30 days or less upon receipt of necessary documentation.
- Electronically submit MSAs to expedite CMS approval.
Allsup also provides free audits of individual claims or blocks of claims and provides free nationwide copy service for claims.