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Medicare Set -Aside Proposals

Medicare Set-Aside  Arrangement Proposals

Medicare Set-Aside Arrangement (MSA) is a financial agreement that allocates a portion of a claim settlement to pay for future medical services related to the injury, illness, or disease.  
Medicare Secondary Payer (MSP) provisions require protecting Medicare’s interests when resolving cases that include future medical expenses. The recommended method to protect Medicare’s interests is an MSA. (

The process of preparing MSA Proposals involves:

  • Conducting a review of medical records, pharmacy history, payment history, and other relevant documents.

  • Identifying Medicare reimbursable medical services related to the accepted compensable injury, illness, or disease.

  • Researching relevant clinical guidelines to support healthcare needs when the information in the records is inadequate.

  • Researching reliable healthcare cost data of the relevant jurisdiction.

The Electronic Submission service of WCMSA proposals to Medicare is available when indicated and requested. 

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