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As Defense, defendants may be liable for up to three years, if the plaintiff doesn’t use his settlement funds in compliance with the MSP Act. Further, the MMSEA §111 reporting requirements will give CMS the ability of an immediate cross check if Medicare beneficiaries spend their allocated funds in violation of the MSP Act.​

As Plaintiff, CMS has interpreted the MSP Act to require that funds must be used for medical expenses that are Medicare-allowable and related to the injury. Some courts have held that plaintiff’s attorneys are responsible for up to six years from the time they receive the judgment/settlement funds.​

As Claimant, CMS has stated the entire settlement amount could be at risk if an MSA (approved or not approved) is not properly administered.

MAIL ALL CORRESPONDENCE TO:
Two Lakeway Center
3850 North Causeway Suite 400
Metairie, LA 70002
Phone: 504.831.2141 • 800.443.7351
Fax: 504.837.2566 • 800.878.5080

MEDICARE SECONDARY PAYER ACT

maps®LIEN RESOLUTION SERVICES (LRS) provides the administration needed to assist clients in complying with the Medicare Secondary Payer Act, and takes the burden off of the claimant to create and appropriately manage a Medicare Set-Aside Arrangement (MSA). LRS' professional team guides attorneys and claimants through the process, from obtaining a Case ID #, to calculating the amount of future medical funding account (MSA).

WHAT YOU SHOULD KNOW

As one of the United States Courts of Appeal recently observed, the Medicare Secondary Payer Act “is not a model of clarity. Yet, it does clearly provide that, where there is some entity, other than Medicare, obligated to pay for an item or service, that entity shall pay first and Medicare shall pay the excess.” CMS is constantly changing its interpretation of the U.S. Code, the code of Federal Regulations, and in general how to protect Medicare’s interest. 

WHAT YOU SHOULD CONSIDER