Liability Medicare Set Asides (LMSAs) in 2025

Liability Medicare Set-Asides (LMSAs) remain an evolving aspect of Medicare Secondary Payer (MSP) compliance. While no formal LMSA review process exists, attorneys handling liability settlements must still ensure Medicare's interests are protected when future medical expenses are at issue. This session will examine the current legal framework, recent regulatory developments, and practical best practices for addressing future medicals in liability cases. Participants will explore the differences between LMSAs and Workers' Compensation MSAs, review historical CMS guidance, and learn strategies for evaluating whether future medical allocations are required, documenting decisions, and mitigating client and attorney risk.

Learning Objectives:

1. Explain the statutory basis for Medicare's recovery rights for future medical expenses in liability settlements
2. Distinguish between LMSA and WCMSA requirements, processes, and reporting obligations
3. Evaluate CMS guidance and policy documents, including the Treating Physician Memo and Region VI Handout, to determine LMSA applicability
4. Apply a structured approach to assessing whether a liability settlement includes funds for future medical care
5. Implement best practices to document LMSA decisions and protect client access to Medicare benefits