Home | Solutions | News, Blogs & Events | State Info | Kids' Chance



Thread Rating:
  • 0 Vote(s) - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5

CA - Can there be 2 Medicare Set Aside (MSA) analysis
#1
Question 

The defense attorney submitted to a company, to obtain a Medicare Set Aside analysis, determining future medical expenses which would be covered by Medicare related to my WC injury.

Here is the problem: When I moved out of CA [4 years into my injury] WC stopped paying for everything ... medical and prescriptions. For 5+ years I have been paying these expenses myself. The Defense only submitted documents and records from California. I continue to be on the identical medications and in the same dosages, as when I was in CA, however all this information was not passed along and therefore the MSA has no such record of my requiring these daily medications or current related costs ... resulting in the MSA coming back from the Company on the low side.

When I first received the Company anaysis, I called and submitted to them my prescription costs etc. which were not submitted by the Defense. Apparently to no avail.

May I submit to a WC Judge not all information was provided to obtain a 2nd review of the case?
Reply
#2

the judge does not make the medicare set aside amount decision; only medicare does.
you can submit a separate MSA request to CMS.
you may not be able to come to an acceptable settlement agreement with the carrier because of this issue.

Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
Reply
#3

The defense only submitted to the company a partial medical record, of course not including the prescription costs I have incurred these past 6 years, to where social security CMS came up with ... just take an asprin. Having RSD is not an asprin fix.

How does one find another MSA company to generate another report to submit to CMS?
Reply
#4

phonebook.
search engine.
contact cms
contact atty
contact carrier.

a third party vendor is not required or the same vendor can submit a revised recommendation.

Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
Reply


Forum Jump:


Users browsing this thread: 1 Guest(s)