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Medicare (MSP) Solutions

Save Money & Stay Compliant

Cost saving solutions that also account for Medicare's interests.

Compliance

Future Care Conundrum

When Medicare is not the primary payer, settling parties must account for Medicare's future interests. Failure to do so can result in denied Medicare benefits, delayed settlements, and significant financial liability for all parties involved.

Grossly unnecessary or inflated costs
Lack of Medicare interest accountability
Danger of not settling the claim
Compliance illustration

Medicare (MSP) Solutions

MSP Compliance You Can Easily Manage

Our Medicare solutions ensure you meet all compliance obligations while minimizing settlement costs. We handle the complexity so you can close claims with confidence.

Built-in Compliance

SOC 2 Type 2 certified processes ensure your Medicare obligations are met with full audit trail documentation and regulatory adherence.

Save Money

Reduce MSA allocations with defensible, evidence-based reports that reflect actual future medical needs without inflated projections.

Speedy Claim Resolution

Fast turnaround on MSA reports and conditional payment resolution means you can settle claims sooner and move on.

MSP Services

Full-Spectrum Medicare Solutions

From MSA preparation to conditional payment resolution, we cover every aspect of Medicare compliance.

  • Medicare Set Aside (MSA) Workers' Comp and Liability
  • MSA Submission
  • Medical Cost Projection
  • Lien Resolution
  • MCP to MSA Conversion
  • Life Care Plan
  • Conditional Payment Identification
  • Conditional Payment Resolution
  • Medicaid Services
  • Medicaid Resolution
  • Medicare Check
  • Social Security Disability Verification

Look at What Our Customers Are Saying

"Ethos MSP solutions have streamlined our Medicare compliance process and reduced our settlement timelines significantly. Their team is always responsive and knowledgeable."

Mike, VP of Claims

"The MSA reports from Ethos are thorough, defensible, and delivered on time. They've made CMS submissions stress-free for our team."

Lori, Claims Specialist

"Since switching to Ethos for our Medicare solutions, we've seen meaningful cost reductions on MSA allocations without sacrificing compliance."

Steve K., Director of Claims

Get Started in 3 Easy Steps

Talk to Us

Tell us about your claim and Medicare compliance needs. We'll recommend the right MSP solution for your situation.

Get Started With Your MSP Coordinator

A dedicated MSP coordinator is assigned to manage your case from start to finish, ensuring nothing falls through the cracks.

Get Your Report Back

Receive your completed MSA, MCP, or resolution report with clear recommendations and next steps for settlement.

Frequently Asked Questions

When does a Medicare Set Aside need to be completed?

An MSA should be considered whenever a Workers' Compensation or liability claim involves a Medicare beneficiary or someone with a reasonable expectation of Medicare enrollment within 30 months. CMS review thresholds and best practices guide when formal submission is appropriate.

What does it mean to be in the waiting period?

The waiting period refers to the time between when an MSA is submitted to CMS for review and when CMS issues its determination. During this period, settlement cannot be finalized pending CMS approval or suggested modifications to the MSA amount.

When is it appropriate for CMS to review?

CMS voluntary review is appropriate when the claimant is a current Medicare beneficiary and the total settlement exceeds $25,000, or when the claimant has a reasonable expectation of Medicare enrollment within 30 months and the total settlement exceeds $250,000.

What happens when MSA funds are exhausted?

Once MSA funds are properly exhausted through appropriate medical expenses, Medicare becomes the primary payer for injury-related treatment. Proper documentation of MSA fund expenditure is critical to demonstrate compliance and ensure Medicare coverage continues.

When should a Medical Cost Projection be considered?

A Medical Cost Projection is appropriate when a claim does not meet CMS review thresholds but parties still want to demonstrate good faith consideration of Medicare's interests, or when a lower-cost alternative to a full MSA is needed to facilitate settlement.

Don't Risk Your Claim Settlement

Medicare compliance is not optional. Protect your organization from future liability with expert MSP solutions that save money and keep you compliant.