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Is Your Claimant Competent To Administer Their MSA?

An evaluation of competence should take place by the settling parties before Medicare Set-Aside (MSA) monies are given to a claimant to self-administer. Unfortunately, everyday in cases all over America, large amounts of money are turned over to injury victims to self-administer their own MSAs with no evaluation of competence whatsoever. Why? Because it is not required. What happens if a seriously injured person does not manage this money properly and fails to follow all the complex rules? They are at risk to lose their Medicare insurance benefits and the Medicare Trust Fund loses money. Allowing incompetent, injured claimants to self-administer their own MSAs is truly a lose-lose situation for the claimant and for the Medicare Trust Fund.

 

Medivest Benefit Advisors proposed to CMS to update the language in their WCMSA Reference Manual to address the claimant, as administrator, be competent. In the May 29, 2014 version of the WCMSA Reference Manual, CMS took Medivest’s suggestion and updated the language of section 17.1.

17.1 Administrators
WCMSAs should be administered by a competent administrator (a professional administrator, the representative payee, the claimant, etc.) When a claimant designates a representative payee, appointed guardian/conservator, or has otherwise been declared incompetent by a court; the settling parties must include that information in their WCMSA proposal to CMS.

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