Does CMS require that a Medicare Set-aside in liability claims?
A29. CMS’ position is that Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (PL 110-173) amends the Medicare Secondary Payer (MSP) provisions of the Social Security Act (Section 1862(b) of the Social Security Act; 42 U.S.C. 1395y(b)) to provide for mandatory reporting for group health plan arrangements, liability insurance (including self-insurance), no-fault insurance, and workers’ compensation. The provisions will begin to be implemented January 1, 2009, for information about group health plan arrangements, and July 1, 2009, for information about liability insurance, no-fault insurance, and workers’ compensation. If you would like more information about the new Section 111 requirements, please visit www.cms.hhs.gov/MandatoryInsRep. Comment: In the case of a settlement of a liability case it is likely CMS will interpret this as a commutation case requiring the establishment of a Medicare Set-aside. In the case of a civil judgment where no future economic damages
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- Does CMS require that a Medicare Set-aside in liability claims?
