Philadelphia RO telling attorneys MSAs are REQUIRED on liability cases

Medicare Set-Aside Blog on October 28, 2010
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I received a call from a lawyer this afternoon who had spoken to the Philadelphia Regional Office. Apparently, she was told that liability MSAs (LMSAs) are required on cases over $250,000 when a Medicare beneficiary is involved.

Typically, CMS is far more cagey when addressing this issue. The fact remains MSAs are never REQUIRED for any case unless there has been an amendment to the MSP of which we are unaware. So regardless of what CMS says, that simply isn’t true.

Nonetheless, we have always believed LMSAs are appropriate and are continuing to see a greater acceptance in the marketplace for their use. But absent a change in the law, nothing is required with respect to MSAs. They are a good risk management tool for the right kind of case and CMS is increasingly willing to review them when it meets their workload thresholds.