Medicare Set Aside Estimates, Allocations
Under federal law, 42 U.S.C. 1395y (b)(2) and 1862(b)(2)(A)(ii) Medicare will not pay for treatment to your workers compensation injuries unless you have taken adequate steps to protect the interests of Medicare.
This law was passed to stop workers compensation insurance companies from shifting the cost of treating workers compensation injuries onto the taxpayers and the social security system.
If you are currently entitled to Medicare benefits or reasonably expect to qualify for Medicare benefits within 30 months and the value of your workers compensation settlement is $250,000.00 dollars of more, you must get approval of a Medicare set aside estimate or allocation (called an MSA) from the Centers for Medicare & Medicaid Services.
The amount allocated for treating your workers compensation injuries must be put into an interest bearing account that is used only to pay for treating your workers compensation injuries. Payments to your doctors should be in accordance with the Florida Workers Compensation Fee Reimbursement amounts.
William H. McKnight in many cases can expedite the preparation of your MSA estimate.