Is there future medical care involved?  Is there a permanent shift of burden?  These things may equate to the need for an MSA (Medicare Set Aside).  Use this equation to determine if an MSA is necessary in your legal case.
FCC + PBS = MSA

The requirement is to protect Medicare’s interest (per SCHIP Section 111)
This can be accomplished formally or informally.  A more formal protection of Medicare’s interest would be in the form of an MSA report.

MSA (where FCC = Future Cost of Care; PBS = Permanent Burden Shift, and MSA …

Claimant Mary Ferreira entered into a settlement agreement that included funds for her to establish a Medicare Set-Aside account. The contract stated that Ferreira, not the employer or carrier, be responsible for administering the account. The agreement also provided that the employer/carrier would deposit seed money in the amount of $10,851.08 and $33,694.64 for the purchase of an annuity that would yield $2,154.18 per year, and that amount was final, not subject to change or approval by CMS.
The parties also agreed that if CMS demanded a larger amount, Ferreira would …

On June 2, 2009, CMS published new guidelines with regard to prescription drug documentation for Medicare Set Aside allocators.  A copy of the memo can be found on the CMS website.
The memo includes these main points:

Pricing of prescription drugs is to be based on the current REDBOOK Drug Reference
Allocators are to use the lowest priced generic drug listed in the reference
Tapering WILL BE CONSIDERED by CMS as recommended by the treating physician
Off-label use does not preclude the prescriptions from the allocation and are allowed so long as the drug is …