LMSAs: CMS thankfully delays LMSA announcement

Lightbulb3-orange.pngOver the past several months there have been direct communications from the Centers for Medicare & Medicaid Services (CMS) that liability Medicare set-aside arrangements (LMSAs) were on the horizon. In this blog we commented on a February announcement from CMS to providers about LMSAs. In the middle of September, CMS released another notice to providers reminding them that Medicare beneficiaries must make out-of-pocket payments for services if they had a workers’ compensation MSA (WCMSA) or a LMSA. These were both strong indicators that a formal LMSA announcement was right around the corner.

Through our membership in the Medicare Advocacy Recovery Coalition (MARC), we were able to communicate with CMS that the LMSA rollout was premature. MARC was able to secure a meeting with CMS senior leadership in late September. We are thankful to CMS for not only having the meeting, but also listening to our concerns and recommendations. Several positives were achieved, including:

  1. CMS rescinded the September communication days after the MARC meeting
  2. CMS stated that no formal LMSA communication is imminent
  3. CMS will honor a promise it made to MARC in 2016 that it will confer with the industry before implementing any formal LMSA communication

A big thank you to our leadership at MARC and CMS leadership in reaching a consensus on the status of LMSAs. We will continue to share updates with our clients and partners as the move toward LMSAs progresses. In the meantime, please reach out to us with your questions.

Michael R. Merlino II, ESQ.
SVP of Medicare compliance and structured settlements

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