WORKERS’ COMPENSATION MEDICARE SET-ASIDE ALLOCATION (WCMSA) REPORTS

Medivest recognizes the important role we play in the settlement of workers’ compensation and personal injury claims and how imperative it is to understand and assist settling parties with Medicare Secondary Payer (MSP) compliance.  A Workers’ Compensation Medicare Set-Aside Allocation (WCMSA) Report is one of the first steps taken in an effort to consider Medicare’s future interest.  Medivest has an outstanding record for providing accurate and timely WCMSA allocations that allow the settling parties to confidently proceed forward with their settlement.

What Is a WCMSA Report?

A Workers’ Compensation Medicare Set-Aside is typically required in situations involving workers’ compensation settlements for individuals who are Medicare beneficiaries or who have a reasonable expectation of becoming Medicare-eligible within 30 months of the settlement date. The purpose of a WCMSA is to ensure that funds are set aside to cover future medical expenses related to the workplace injury or illness, which would otherwise be covered by Medicare.

When a WCMSA is established, a certain amount of money is allocated from the workers’ compensation settlement specifically for future medical expenses. This amount is based on the estimated cost of the injured worker’s future medical treatment, including doctor visits, hospital stays, surgeries, medications, and other related expenses.

The funds in the WCMSA account are to be used exclusively for injury-related medical care until they are exhausted. Once the WCMSA funds are depleted, Medicare becomes the primary payer for any remaining medical expenses.

The WCMSA process typically involves a detailed review of the injured worker’s medical records, treatment history, and projected future medical needs. The goal is to determine a reasonable and adequate amount that will cover the expected medical expenses while ensuring compliance with Medicare guidelines.