Medical Cost Projections & Medicare Set Asides (MSAs)

 

Our Cost Projection Services Provide Additional Protection for Your Clients

Build the value of your case by uncovering hidden dollars that increase settlement value while protecting your client’s future medical benefits. Our team has over 30 years of experience recognizing ‘undiscovered’ medical care and possesses a wealth of knowledge in preparing the proper reports that allow for future expenses to be taken into consideration.

We can help identify those dollars with a Non-Medicare Cost Projection to uncover any costs missed by a Medicare Set-Aside. MASSIVE also offers Full Medical Cost Projections to determine the true future medical cost needed for a case. Each of these can be bundled with a formal Medicare Set-Aside to further protect plaintiff and defense alike.

MASSIVE can help safeguard a plaintiff's future medical benefits. MASSIVE’s team of experts have years of experience evaluating workers’ compensation and third-party liability cases, satisfying Medicare’s past interests and identifying future medical allocations. 

After a case evaluation, we will determine if a Medicare Set-Aside (MSA) may be required to protect Medicare’s future interest.

Although no official guidelines have been issued by the Centers for Medicare and Medicaid Services (CMS) for liability cases, as recent as October 2017, Medicare has made public statements that the agency believes Medicare Set-Asides are the best method to protect the program from paying for the injury-related care when future medicals are funded by a settlement. MASSIVE provides the expertise, accuracy and timeliness you need when determining medical care costs, helping you obtain better outcomes.

MASSIVE Offers a Variety of Cost Projection Reports

We have established multiple Medical Cost Projection services to ensure the reports we create successfully advocate for your clients. We have spent countless hours perfecting our Cost Projection services to benefit your clients far beyond settlement, and allow you to take back contol of cases that need these services. Dont let the defense be the sole driver of value any longer.

Our cost projections are broken down into different formats in order to tailor to your client's specific needs. MASSIVE can create:

Non-Medicare Cost Projection (NMCP) -

  • This projection determines what medical costs will be missed by an MSA. It is used as a supplement to an MSA as it only considers items that Medicare generally does not pay. This will not be a complete projection for someone who is not covered by Medicare. All cost projections include non-medical costs such as home and vehicle modification, professional household services like gardening, transportation costs, and more.

Full Medical Cost Projection -

  • This projection determines all future medical costs, but does not separate between Medicare and non-Medicare. This is the best option to project all future medicals for a person not covered by Medicare.

Medicare Set-Aside (MSA) -

  • This allocation determines what medical costs Medicare would pay for, if it was the primary payer for the sued-for injuries. It will not include medical costs that Medicare generally does not pay for (such as the pharmaceutical drug Lyrica). Includes one free, pre-submission revision to your MSA.

Medicare Set-Aside + NMCP -

  • This projection includes an MSA and Non-Medicare Cost Projection and separates each payment between those that Medicare pays and those they do not. We recommend this cost projection be used to compare to a defense MSA.

Our Services Extend Beyond Cost Projection Reports

We know that there is still work to be done after the Medical Cost Projection reports are completed. We offer further assistance beyond compiling your client's future medical allocations. Our additional services include:

MSA Submission to CMS -

  • We will only submit the MSA to the Centers for Medicare & Medicaid Services (CMS) with your permission. Please note that CMS likely will not review Liability MSAs.

MSA Self-Administration Kit -

  • We provide you with the tools you need, in order to help your client manage their settlement dollars.

MSA Professional Administration -

  • Allow our trusted partner to finalize your Medicare Set-Asides and make sure that your client is covered after settlement.

Our Cost Projection Services Provide Additional Protection for Your Clients

Build the value of your case by uncovering hidden dollars that increase settlement value while protecting your client’s future medical benefits. Learn how our Medical Cost Projections can allow you to take back control of cases and reach higher settlements.