LIABILITY MEDICARE SET-ASIDE (LMSA)
ALLOCATION STUDY SERVICE
A Liability Medicare Set-Aside (LMSA) is an amount a Medicare plaintiff voluntarily reserves from their personal injury settlement. Specifically, to pay for injury-related, Medicare-allowable healthcare expenses during that Medicare plaintiff’s lifetime.
Medicare has stated that without any evidence that a plaintiff/claimant considered how to protect the Medicare Trust Fund from becoming a “first payer,” Medicare can take the position that the entire settlement amount must be spent on incident or accident-related medical bills before Medicare will pay one thin dime.
While not (yet) legally necessary, CMS officials have publically stated that LMSAs appear to be a good option. In particular, for helping injury victims manage their Medicare liability by segregating funds for payment of future Medicare bills. Reasonable drafting by qualified, specially-trained medical professionals ensures that the amount recommended to fund a voluntary LMSA is much, much less than having to spend the entire settlement amount.
Therefore, a voluntary LMSA should cap a plaintiff’s exposure to Medicare at a fraction of the entire settlement. Thus, limiting the amount Medicare-allowable costs can claim from a settlement.
Talk to us about how an outside legal opinion from a top Medicare attorney may be able to reduce your client’s LMSA even further.
The result? More for your clients, less for Medicare.