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Medivest’s MSApex Solution

Medivest’s MSApex Solution helps settling parties satisfy their Medicare Secondary Payer compliance obligations faster and for less by funding a Medicare Set-Aside with a reasonable amount, and then arranging professional administration.

You will be providing better MSP compliance, in less time, for less money.

The MSA Dilemma

The law requires that you consider and protect Medicare’s interests in your settlement. The Centers for Medicare and Medicaid Services (CMS) suggests guidance on how to accomplish this. The dilema is that the basis for this suggested guidance often seems unrealistic and can result in excessively large MSAs. Also, submitting the MSA to CMS for review adds time to the settlement process.

Surprisingly, the CMS’ suggested guidance is only one of many possible methods to comply with the Medicare Secondary Payer Statute.  There’s no legal requirement to follow their guidance. The law requires that Medicare’s interests be reasonably and adequately considered to prevent an inappropriate shift of the responsibility for future medical costs to the Medicare Trust Fund.

Finally, There Is a Better Way

Medivest’s MSApex Solution reduces allocations and settles claims faster while still complying with the Medicare Secondary Payer Statute.

The Best MSP Compliance Solution

Medivest’s MSApex Solution is a fully compliant Medicare Secondary Payer (MSP) compliance method that results in:

Smaller
Medicare Set-Aside (MSA)
Allocations

Faster Settlements

Better Protection
of the
Medicare Trust Fund

How Medivest’s MSApex Solution Works

Medivest’s MSApex Solution produces MSAs that are prepared at prices Medivest is able to secure as the nation’s leading professional administrator.  Medivest’s buying power is leveraged to ensure savings and complete MSP compliance.

  • Medivest will prepare a Medicare Set-Aside allocation that adequately considers Medicare’s interests using pricing Medivest has secured from its network of pharmacy and medical vendors thereby substantially reducing the total of the MSA.
  • Medivest’s Professional Administration Services will be utilized to secure the MSA pricing and ensure that the MSA is only used to pay for Medicare allowable expenses related to the injury.
  • Since the CMS’ review process only applies to MSAs prepared using the CMS’ specific methodology there is no reason to submit the SMA for review by the CMS.

The total realized MSA reduction more than covers the professional administration costs, resulting in a small settlement with greater Medicare Secondary Payer compliance.

Now you can fund an MSApex Allocation and arrange Professional Administration FOR LESS than funding a conventional MSA Allocation.

Consider how Medicare Secondary Payer compliance using Medivest’s MSApex Solution compares to MSP compliance handled using today’s conventional methodology, using a real workers’ compensation allocation prepared in 2015:

Conventional MSA

Future Medicare allowable medical expenses addressed using the CMS’ voluntary guidance:

Medicare Set-Aside:
Rated Life Expectancy 22 years
Future Prescriptions $140,818
Future Medicals $50,472
Medicare Set-Aside Total $191,290

 

CMS Submission:
CMS Submission Cost $1,000
Delay due to CMS Submission 120 days
CMS Counter-Higher $7,651

 

MSA Administration: Self-Administered
Setup Fee: $0
Annual Fee: $0
Total Fees (over life expectancy) $0

 

Grand Total: $199,941

Future Medicare allowable medical expenses addressed using Medivest’s MSApex Solution:

Medicare Set-Aside:
Rated Life Expectancy 22 years
Future Prescriptions $74,131
Future Medicals $47,948
Medicare Set-Aside Total $122,079

 

CMS Submission:
CMS Submission Cost $0
Delay due to CMS Submission 0 days
CMS Counter-Higher $0

 

MSA Administration: Professional Administration
Setup Fee $950
Annual Fee $555
Total Fees (over life expectancy) $13,160

 

Grand Total: $135,702
Savings Total: $63,704
Savings Percentage: 32.4%

Further savings of up to 40% could also be realized by utilizing a structured settlement annuity to fund the Medicare set-aside and administration fees.

Medivest’s MSApex Solution generates substantial savings while being fully compliant with the MSP statute. And, with professional administration, the strongest MSP compliance tool available, you’ll be taking definite steps to make sure Medicare remains a secondary payer for the injury post-settlement.

Put Medivest's MSApex Solution to Work for You!

Call Medivest today at 877-725-2467, or email us at msapexinfo@medivest.com.