Do I have to deal with the MSP?
Question:
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 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.
Answer:
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.
Posted by Medicare Set Aside Services at 1/13/2010 8:51 PM 
Categories: uncategorized
Tags: Medicare Set-Aside MMSEA Liability
Categories: uncategorized
Tags: Medicare Set-Aside MMSEA Liability
Emigrating to Europe, how to administer Medicare Set Aside to pay for private treatment overseas. Multiple injury case, definite future surgeries and care needed. Not intending to reside in U.S. again, eligible but will not use Medicare. How would MEDVAL administer MSA? Cost? Annual reporting method?
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I'm glad to see that in discussing "exposures" -- which are important for toxic tort cases -- you are emphasizing the "released" part of the equation. From what we're hearing from our national clients, a lot of lawyers are telling corporate America that there is no reporting or obligation if the exposure was all before 12/5/80, and that isn't what CMS is saying. Can you imagine a company settling a large exposure case and NOT getting a release for all exposures, whenever they occurred? Seems to me that so long as this is the scope of the release, it includes exposures after the cut-off, and there's a potential need to report. And if the plaintiff's attorney broadly alleges exposure in the complaint, even if there is no way really that any exposure took place after 12/5/80, then it seems likely there is an obligation to report.
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