Begin Main Content Area

Medicare Policy: Evaluation and Approval
of WC Lump Sum Settlements

The Centers for Medicare and Medicaid Services website is a valuable source for help in seeking Medicare approval of a workers' compensation settlement. Of particular interest is their coordination of benefits page that includes material specific to workers' compensation settlements, such as and overview and links to material such as:
 
1.
Provides questions and answers as guidelines for the Medicare Regional Offices concerning the obligations of Medicare recipients who are also receiving workers' compensation benefits. Scroll down the page for links to memoranda dated on or before July 11, 2005. The page now links to the December 30, 2005, memorandum addressing prescription drugs benefits and Set-Aside Arrangements.
2.
A summary of basic principles the Centers for Medicare and Medicaid Services (CMS) applies to workers' compensation medical settlements.
3.
Workers' Compensation Medicare Set-Aside Arrangements (WCMSAs) - Approval Process
Describes the process for submitting a proposed set-aside arrangement for CMS approval. Scroll down the page for links to useful documents, such as a checklist and a sample submission.
 
For more on Medicare and workers' compensation:
 
Additional information on Medicare and workers' compensation can be found on the Centers for Medicare & Medicaid Services website.