Who may be an “administrator” to a Medicare Set-aside?
A27. Medicare Set-asides must be administered by a competent administrator. This can be the beneficiary, a representative payee for Social Security purposes pursuant to 20 C.F.R. ” 404.2010 and 404.2015 (e.g., because the individual is legally incompetent, mentally incapable of managing benefit payments, etc.), an appointed guardian or conservator or a professional administrator. Moreover, when an individual has a designated representative payee, appointed guardian/conservator, or has otherwise been declared incompetent by a court then the party submitting the Medicare Set-aside proposal to CMS must include that information as part of their proposal to CMS. Q28. Is there a means by which an injured party can permanently waive his or her right to certain specific medical services or prescription drug coverage arising from a work or accident related injury or illness and thereby eliminate the need for or reduces the amount of a Medicare Set-aside? A28. No, CMS cannot approve settlements
Related Questions
- What is CMS= policy regarding the inclusion of prescription drugs in a Medicare Set-aside with the implementation of the Medicare Modernization Act of 2003 (MMA)?
- When a state workers= compensation Commissioner, Judge or Administrator approves a settlement will Medicare accept the terms of that settlement?
- Who may be an "administrator" to a Medicare Set-aside?
