Medicare Compliance

$88M

Conditional
Payment Savings

200K+ MSA

Submitted by Life Care Planners & Doctors of Pharmacy

Comprehensive MSP Compliance While Resolving Claims Efficiently

ECS offers a substantial portfolio of services to assure compliance with all aspects of the Medicare Secondary Payer statute. At settlement, ECS Medicare Set-Aside (MSA) options allow parties to swiftly and economically resolve claims with options for submitting to Medicare for prior approval or using our vast clinical and compliance resources to implement an evidence-based approach.

Medicare Set-Aside

ECS employs the most-credentialed and experienced team of Medicare Set-Aside professionals in the industry today. This powerful combination of professional and clinical experience ensures superior accuracy and enables ECS to offer a number of services designed to assess post-settlement medical needs and meet the federal mandate to mitigate/eliminate the potential for any post-settlement medical care costs to be incurred by Medicare. All MSAs are completed by one of ECS’ fulltime Certified Life Care Planners (CLCPs).

Evidence-Based Medicare Set-Aside (EBMSA)

ECS’ EBMSA is designed to create an “evidence-based” approach to a Medicare Set-Aside that applies quantitative and qualitative clinical analysis utilizing established evidence based standards of care. While our client will not intend to submit to CMS for review and approval, the EBMSA provides a medically and legally defensible assessment of the claimant’s future medical needs from our certified life care planners and Doctors of Pharmacy. When the EBMSA is professionally administered, ECS will indemnify, defend and hold harmless the TPA, Employer, Carrier and Injured Worker against future enforcement by Medicare for the claimant’s life expectancy.

Liability Medicare Set-Aside (LMSA)

The Liability MSA from ECS outlines projected post-settlement Medicare-covered medical treatment and prescription drug costs that would otherwise be paid for by Medicare. Each MSA includes a medical case summary with the claimant’s Medicare/Social Security status; itemization of co-morbid pre-existing conditions; a summary of current treatment; and future care recommendations.

Conditional Payments

Comprehensive Conditional Payment solutions remove the worry, inconvenience, and liability of adjuster-handled processes. Prior to settlement, ECS’s conditional payment services automatically capture dispute and appeal possibilities. This early data capture, reduces Treasury collection incidents by over 70% and total amounts owed by upwards of 95%.

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