There has been much discussion on liability MSA’s.  Are they needed?  Not necessary?  Conflicting reports and a statement by the AAJ has continued to make things complicated.  As a Medicare Set Aside allocator, my position is that Medicare’s interest must be protected per Section 111 of the MSP.  I have outlined a simple equation here for quick reference.

Mr. Synder recented posted a comment on LinkedIn as to his thoughts.  I found it well stated.

Link to statement by AAJ

Nothing in the quotes AAJ cites undermines the insurance industry’s position. Medicare could always seek reimbursement of a conditional payment from the insurance carrier– as well as from the plaintiff’s attorney! The new reporting law allows Medicare to connect the dots and deny payment for treatment which matches the body part code, diagnostic code and occurrence date of the report.
Any plaintiff’s attorney who tells his client that an allocation, i.e., set-aside, is unnecessary puts the client at risk for loss of Medicare benefits, and possibly is putting his/her own E&O insurance on the line.
By Teddy Snyder (Linked IN)

The MARC group is seeking transparency between CMS and Primary Plans wtih resprect to conditional payment information, application of state law in the determination of the amount of conditional payments that may be collected, a right of review of CMS decisions on conditional payments, and clear methods of the identification of who is “Medicare eligible” by a primary plan.

Attorny Bill Van Wambeke is the NAMSAP representative on the committee.  If you would like additional information on the issues being raised in Washington, please visit the MARC website at www.marccoalition.com. 

CMS has announced it intends to clarify the language in recovery scenarios where occupational exposures occurred prior to the effective date of the Medicare Secondary Payer Act.  In a recent town hall meeting, Barbara Wright, Bill Decker and others explain some of the reporting requirements and have plans to further clarify the Medicare as Secondary Payor recovery language.  Additional town hall meetings have been scheduled as CMS ramps up for the upcoming mandatory reporting requirements.  Stay tuned..