Flagship Services Group specializes in Medicare Secondary Payer (MSP) Compliance services.
Combining years of experience in the Medicare market with consistent monitoring of Medicare’s ongoing changes, we specialize in implementing processes and procedures to keep you compliant.
As a privately held company, Flagship’s priority is to offer a consultative and flexible approach in creating a unique customized program for each of our clients. We provide several innovative solutions, depending on your needs. Our goal is to form a partnership to ensure compliance while providing the highest level of customer service.
Flagship’s team of experts pride themselves on offering the highest quality of customer service while providing a world class experience that makes you – the customer – feel valued!
According to the Centers for Medicare and Medicaid Services (CMS)
A Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) is a financial agreement that allocates a portion of a workers’ compensation settlement to pay for future medical services related to the workers’ compensation injury, illness, or disease. These funds must be depleted before Medicare will pay for treatment related to the workers’ compensation injury, illness, or disease.
All parties in a workers’ compensation case have significant responsibilities under the Medicare Secondary Payer (MSP) laws to protect Medicare’s interests when resolving cases that include future medical expenses. The recommended method to protect Medicare’s interests is a WCMSA.
The amount of the WCMSA is determined on a case-by-case basis.
Medicare is required by statute (42 U.S.C. § 1395y(b)) to seek reimbursement for conditional payments related to the settlement. Further, Medicare is prohibited from making payment where payment has been made (that is, where the beneficiary obtains a settlement, judgment, award, or other payment). Medicare remains the secondary payer until the settlement proceeds are appropriately exhausted.
42 CFR 411.46 requires that all WC settlements must adequately consider Medicare’s interests, and that, if a settlement appears to represent an attempt to shift to Medicare the responsibility for payment of medical expenses for the treatment of a work‐related condition, the settlement will not be recognized.