How Professional MSA Administration Can Break a Workers’ Compensation Settlement Deadlock
Sometimes reaching a settlement agreement isn’t easy. Even when both parties are eager to resolve a case, negotiations can hit a wall. That’s because successful negotiation always requires compromise. Each side must be willing to give a little to gain a little. But what happens when both parties reach an impasse and can’t find a solution that works for everyone?
This is where offering Professional Administration can become a game-changing strategy. By introducing this option during negotiations, you can provide a creative solution that adds value for both sides, reduces future risk, and makes compromise more appealing.
Why Do Settlements Stall?
Settlement negotiations can break down for several reasons, including:
- Disputes Over Future Medical Costs: Parties can’t agree on the value of future care or the size of the MSA.
- Fear of Mismanaging MSA Funds: An injured individual may hesitate to settle if they don’t feel confident managing Medicare money on their own.
- Compliance Concerns: Payers worry about post-settlement compliance and possible CMS scrutiny.
- Disagreements on Reversion Interest of Unused Funds: Parties clash over what happens to unspent MSA funds after the injured party passes away.
- Who Pays for Professional Administration: Both sides may see it as “the other party’s responsibility.”
- Distrust or Unclear Communication: Settlement language or responsibilities may feel too vague, leading to hesitation or second-guessing.
Any one of these issues can stall negotiations for weeks, months or even longer.
The Fix: Professional MSA Administration
Professional Administrators take full responsibility for managing the Medicare Set-Aside (MSA) account, ensuring funds are spent properly, reporting is handled, and Medicare compliance is maintained. By offering Professional Administration during the negotiation process, it can help move the case towards settlement. The following are ways Professional Administration can help your settlement.
- Flexibility in Payment – Either Side Can Fund It
One of the most appealing aspects of Professional Administration is that either party can choose to cover the cost. Whether the payer wants to protect their financial exposure, or the injured party wants peace of mind, the fee can be allocated however the parties see fit. In return, the injured individual’s medical funds are professionally managed, reducing the risk of misuse and ensuring that all expenditures comply with Medicare Secondary Payer (MSP) guidelines. - Post-Death Fund Distribution Options
With Professional Administration, any unspent medical funds aren’t lost in a void. Instead, the parties can negotiate in advance on how those remaining funds will be dispersed. The funds may revert to the funding party, be distributed to a named beneficiary, passed to the injured individual’s estate, or any combination thereof. This flexibility adds a layer of value to the settlement that can help both sides reach an agreement faster. - Risk Transfer and Compliance Assurance
Managing a MSA properly is no small task. If funds are misused or not spent according to CMS rules, it can trigger serious consequences, including potential penalties and a loss of future Medicare benefits. By utilizing a Professional Administrator, both parties can offload this burden to a trusted third party. If a mistake occurs, the administrator, not the injured individual or the funding party, is responsible for making it right. This layer of protection provides peace of mind for all involved and ensures long-term compliance.
Bottom Line
When negotiations stall, offering Professional Administration isn’t just a logistical solution, it’s a powerful tool for bridging the gap. It helps protect all parties, enhances the value of the settlement, and can be the key to moving a tough case toward resolution.
About Medivest
Founded in 1996, Medivest is a national Medicare Secondary Payer (MSP) compliance company and provider of settlement solutions. Our focus is assisting anyone settling a workers’ compensation or personal injury claim to understand their obligation to consider Medicare’s interests under federal law. Medivest provides pre- and post-settlement solutions that help mitigate exposure from that obligation. Contact us today at 877-725-2467 or medivest.com/contact-us.
