Medicare Risk Alert: Favorable MSA Approval
Teague Campbell’s Medicare Settlement Solutions team recently obtained a favorable MSA approval from CMS in a case where the plaintiff sustained a compensable back injury in 2002. He was provided authorized medical care until his release in 2009, when his authorized treating orthopaedist indicated that he would not need any additional treatment. In 2012, an outside MSA vendor was hired to prepare a MSA proposal. The proposal recommended a MSA in excess of $288,000, based largely on medications prescribed for unrelated conditions. Teague Campbell’s Medicare Settlement Solutions analyzed the file materials and relevant issues, and worked with the parties to formulate a strategy for more accurately projecting the lifetime Medicare-covered expenses specifically related to the at-work injury. Medicare Settlement Solutions prepared a new MSA proposal and handled submission of this proposal to CMS. CMS approved the new MSA amount with total funding of less than $9,000, which resulted in significant savings and ultimately allowed the parties to proceed with full and final settlement of the claim.