The MSCC certifies professionals in the preparation of Medicare Set-Aside allocations for workers' compensation and liability settlements. Scope includes identifying injury-related, Medicare-covered future care, pricing it under the applicable fee schedule, and documenting the allocation in a form that satisfies Medicare's review process and protects the parties' interests.
Medicare Set-Aside reports are primarily settlement and compliance documents rather than trial exhibits. Testimony arises when the allocation methodology is disputed, for example over which future care is injury-related or Medicare-covered, and in that setting the MSCC's documented methodology and pricing sources are what is examined.
When a settlement closes future medical benefits and the claimant is a Medicare beneficiary or has a reasonable expectation of enrollment within the period Medicare's guidance addresses. Counsel and the MSCC confirm the review thresholds and current guidance for the specific settlement.
Both project future injury-related care from the same records and physician recommendations. The set-aside is limited to Medicare-covered items priced under the fee schedule; the life care plan covers all reasonable future care at the pricing appropriate to the case.
Yes. The methodology is similar, though liability allocations involve additional judgment about apportionment and the absence of a formal review program comparable to the workers' compensation process.
Contact our team to discuss how KW Life Care Planning can support your case with certified life care planning expertise. Request a Consultation or call (201) 343-0700.