Life Care Planning & Medicare Set Aside Projections

Life Care Plan Development
A Life Care Plan (LCP) is a tool used in the administration and litigation of catastrophic injury claims or persons who have long term health care needs related to a chronic illness. A life care plan provides a comprehensive assessment of the current and future medical and rehabilitative needs of a person over their lifetime. Life Care Plans are used extensively to determine the long term financial exposure to a carrier or to help evaluate a claim for settlement value.

Medicare Set Aside Allocations
Medicare Set Aside (MSA) allocations ensure compliance with the Medicare Secondary Payer Statute on injury settlements. MSA services from Momentum are highly flexible and may include any number of services. In general, our typical MSA includes a complete file review, execution of appropriate medical releases, projection of future medical needs and submission and tracking of the MSA to the appropriate CMS Regional Office. A Momentum MSA will provide a complete and accurate picture of Medicare’s expected future medical exposure, by utilizing Medicare's current reimbursement guidelines in determining eligibility and coverage for future medical treatment.

Momentum’s objective in developing an MSA, is to produce a highly defensible work product that will stand up to CMS scrutiny. Per Medicare guidelines, an MSA is required for any settlement meeting the following criteria:

1.  Is the claimant a current Medicare beneficiary?
2.  Will the claimant become a Medicare beneficiary within 30 months of the date of settlement and is the anticipated settlement amount, including indemnity, expected to be greater than $250,000 dollars?