The Medicare Set Aside Gold Rush
There seems to be no end to the number of firms willing to hang a shingle and add Medicare Set Aside services to their service offerings. We always like to say that the Medicare Set Aside business looks deceptively easy from the outside and a bad MSA doesn’t look much worse than a good one. Sometimes, they even look better. It seems anyone that attends the weekend course to get an MSCC certification feels perfectly comfortable holding themselves out as an expert regardless of actual experience while blissfully ignoring the damage they can do to their clients (whether working for the insurer or claimant).
Case in point. We were recently retained to evaluate a $650,000 MSA prepared by one of those PBM owned Medicare Set-Aside firms. Aside from the Medicare Set Aside being overfunded by approximately $350,000, the claimant was only 26 years old with a date of injury in 2004. Since he was 22 at the time of injury, it was immediately apparent that the claimant likely did not have enough quarters of earnings to be SSDI eligible. This fact was subsequently confirmed by a check with the Social Security Administration. So instead of a $650,000 MSA, the client needed a special needs trust and an MSA of $0.
So this Medicare Set Aside provider could have cost their client $650,000, rendered a severely injured claimant ineligible for government assistance and would probably keep right on whistling by the graveyard.
For Medicare Set Asides prepared by expert attorneys and medical professionals, call MEDVAL at 888-SET-ASIDE.
MEDVAL 1-888-SET-ASIDE (1-888-738-2743)
Medicare Set-Aside Allocation/Arrangement Recommendations
Submissions to Centers for Medicare and Medicaid Services
Pharmacy Benefit Management