MEC Connect

Demystifying Medicare Set-Asides in Workers Comp


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Medicare Set-Asides (MSAs) represent a critical factor in the workers compensation settlement landscape, yet they remain widely misunderstood by many professionals in the industry. In this Expert Insights episode, "Demystifying Medicare Set-Asides in Workers Comp," MEC’s Medical Management Consultant, Tina D’Andrea, unpacks how a properly executed MSA ensures compliance with Medicare requirements and provides clarity and protection for all parties involved in the settlement process.

Tina shares insights about fundamental components of MSAs—from threshold requirements to submission procedures to review and appeal options— to help claims professionals better understand and navigate the complex process more effectively. This includes:

  • Centers for Medicare and Medicaid Services thresholds that determine when an MSA should be submitted for their review.
  • Why the MSA submission process requires meticulous documentation and attention to detail.
  • Remediation pathways that can save thousands of dollars and countless headaches. 
  • Re-review options for mathematical errors, missing documentation, or significant pricing changes
  • The vital importance of working with experienced MSA vendors for best results.

Listen now to get the guidance you need to successfully address the challenges of Medicare Set-Asides and approach your next workers compensation settlement with clear focus and confidence. 

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MEC ConnectBy Midwest Employers Casualty