Be Careful of Prescription Allocations on MSA's

Posted on December 7, 2006 by Karen Shelton

When settling a case (mainly workers comp) with a MSAT' (Medicare Set Aside Trust), a number of allocators are calculating costs of prescription for a period of five years only, rather than lifetime. CMS will not approve the allocation if the prescriptions are going to be for a longer period of time.  Here's an example:

  • Plaintiff lifecare plan shows about $200,000 in prescription medication
  • Defense lifecare plan shows about $120,00 in prescription medication
  • the MSA shows $22,000 in prescriptions (based on the first five years only)
CMS will not approve the prescription medications and the client will get caught in the middle. So carefully review the period of time that prescriptions are calculated for in MSA's and request a revision.

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