A Lack Of Guidance Is Causing Confusion In Workers’ Comp Liability Claims

The Centers for Medicare and Medicaid Services’ (CMS) current approach to workers’ compensation liability claims is leading to consternation and confusion among many industry insiders, it has been suggested. Unlike in workers’ compensation practice, CMS has not issued any guidance regarding the use of Medicare Set-Asides (MSAs) in liability cases as a means of complying with the Medicare Secondary Payer (MSP), according to Robert L Sagrillo, chief compliance officer, NuQuest. The MSP law applies equally to workers’ compensation and liability claims, yet CMS, and many in the claims industry, have incorrectly assumed that an MSA is necessary in workers’ compensation claims, he suggests. Conversely, those in the liability area assume that nothing is required to consider Medicare’s interests in liability settlements since CMS hasn’t issued guidance.