Protecting medicare's future interest

Protecting Medicare’s Future Interest When CMS Declines to Review MSA Proposal: Schexnayder and Smith.

Two recent orders from the United States District Court provide new guidance on how settling parties may achieve absolute Medicare compliance when CMS chooses not to review a MSA proposal. In both Schexnayder and Smith, CMS review and approval of the MSA proposal was a condition precedent to final settlement. CMS declined to review the MSA proposal in either case. Each Court, upon reviewing the MSA proposals in light of the evidence presented, agreed that Medicare’s future interest would be protected by funding the MSA in the amount set forth in each MSA proposal.

As part of GRG’s commitment to monitoring decisions affecting settlements and future cost of care issues such as MSAs, this paper addresses the court’s decisions and potential impact of Schexnayder and Smith.

The Garretson Resolution Group specializes in settling health care liens and reimbursement claims with federal (Medicare), state (Medicaid) and private/ERISA health insurance providers in single event and mass tort settlements. In fact, GRG evaluated and resolved Medicare and Medicaid’s interest in over 50,000 cases last year alone. Simply put, we know the process.

Among the tips included in this pamphlet are:

What are the key takeaways from Schexnayder and Smith?

What is the potential impact of these decisions on the submission of MSA proposals to CMS going forward?

How does the involvement of a neutral third party to assess and lend guidance on MSA issues help ensure MSP compliance?