Do I have to deal with the MSP?

Medicare Set-Aside Blog on January 14, 2010 | Posted by


I have heard that an RRE is not required to report certain liability claims if they have a certain date of loss. What does that mean? I have several occupational exposure claims I am working on and am not sure how the MSP applies.


I believe you are referring to claims that pre date the enactment of the Medicare Secondary Payer Act (MSP).
RREs generally are not required to report liability insurance (including self-insurance) or no-fault insurance settlements, judgments, awards or other payments where the date of incident (DOI) as defined by CMS was prior to December 5, 1980. (See exception in discussion below of cases involving “exposure.”)

For claims involving “exposure”, this means that there was no exposure on or after December 5, 1980, alleged, established, and/or released. If any exposure for December 5, 1980 or a subsequent date was claimed and/or released, then Medicare has a potential recovery claim and the RRE must report for Section 111 purposes.  For example, if the date of 1st exposure is prior to December 5, 1980, but that exposure continues on or after December 5, 1980; Medicare has a potential recovery claim.