Professional Administration: The Last Piece of the MSP Compliance Puzzle

It has been nearly one year since the Centers for Medicare & Medicaid Services (CMS) first released a revised Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide,[1] which addressed one of the lesser discussed topics in Medicare Secondary Payer (MSP) compliance: professional administration.  Specifically, the revised guide included the following statement: “[a]lthough beneficiaries may act as their own administrators, it is highly recommended that settlement recipients consider the use of a professional administrator for their funds.” (WCMSA Reference Guide, COBR-Q1-2018-V2.7, Pg. 55). (emphasis added.)  For those unfamiliar with the process, once a WCMSA (whether reviewed/approved by CMS or not) is established, the total WCMSA amount must be placed into an interest-bearing account, separate from any other personal accounts.  From this account, an injured worker must pay for all Medicare-covered services and treatment related to…

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