FAQs


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How long does a Medicare Set Aside take?

The time-frame for preparation of a Medicare Set Aside (MSA) can vary. There are several factors which can play into how long it takes, including the severity of the injuries, complexity of the case, and volume of treatment records involved. Moreover, the availability of records to the MSA allocator / vendor may play in to how long it takes to finalize an MSA. Ametros is aware that industry standards of many of the MSA vendors seem to be between 3-5 business days. There are certain instances where MSA vendors may provide “rush” services to furnish an allocation quicker.

With respect to the Workers’ Compensation Review Contractor (WCRC) reviewing an MSA; if there’s no development of the case, it typically takes an average of 30 days for CMS to issue a decision.  However, CMS’s official timeframes are extended, as indicated in the WCMSA Reference Guide:

When you submit a WCMSA for review, CMS tries to review and decide on proposed settlements within 45 to 60 days from the time that all relevant documents are submitted.

See WCMSA Reference Guide, v.3.1, sec 15.1.

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