The Changes Medicare Needs

2005 Words8 Pages
A number of changes to both state workers' compensation laws and the MSPA would eliminate the problems inherent in the current system. These solutions include modifying state workers' compensation laws to permit the parties to settle only the indemnity portion of the claim in states that do not already do so, applying the MSPA only to cases in which the primary payer is legally obligated to pay, instituting a safe-harbor threshold amount for settlements, creating a right of appeal from Medicare's rejection of a settlement proposal, and allowing claimant's to waive their rights to certain treatments under Medicare. Any one of these changes implemented on its own would be an improvement, but implementing all of them would create a much fairer system.

A. State Legislative Remedies The Medicare set-aside requirement is intended to prevent workers' compensation insurers from shifting the expense of the claimant's future medical treatment to Medicare. It is therefore only a hindrance to settlement when the settlement is intended to include compensation for future medical expenses. Some states have enacted workers' compensation laws that permit the settlement of only the indemnity portion of the claim, ending the insurer's liability for that portion while leaving the medical aspect of the claim open. In such instances, the insurer remains liable for the claimant's future medical treatment, and there is therefore no potential for shifting the cost to Medicare. As such, Medicare
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