A Study of CMS Policy on Treatment Denials for Injured Workers with a Medicare Set Aside

Medicare is systematically denying MSA recipients' claims, and with steady frequency.

Produced with data from researchers at Research Data Assistance Center (ResDac), this is the first study of its kind analyzing quantitatively how often The Centers for Medicare and Medicaid Services (CMS) denies coverage for otherwise Medicare-covered items for individuals after settlement of an insurance claim involving medical liability. See how these denials are severely impacting the treatment of individuals who settled with a WCMSA and how you can take precaution.

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What will you learn from this exclusive study?

  • Data-backed key metrics about the volume and frequency of Medicare denials over the past few years
  • An examination of the correlation between WCMSAs and the Medicare Part B Program denials
  • The broad implications Medicare denials have for the individual and all constituents in the claims settlement process
  • Best practices to ensure individuals are being compliant with CMS’ requirements

Get this exclusive 15-page study brought to you by Ametros through ResDAC research data, a CMS contractor, to avoid the risks of individuals making severe Medicare compliance mistakes after settlement. If you have questions about this study or about how these findings may impact you, please send your inquiry to research@ametros.com.

Browse Our Resource Center

The Ametros Resource Center has a collection of useful videos, brochures, and links to help you learn about Workers' Compensation, Medicare Set Asides, and more.

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