The MSP Act is Confusing.
The MSP Act Says ...
"Payment ... may not be made ... to the extent that payment has been made ... under a workmen's compensation law or plan ... or under an automobile or liability insurance policy or plan (including a self-insured plan) or under no fault insurance." 42 U.S.C. Sec. 1395y(b)(2).
The MSP Act Means ...
... to the extent that a workers' compensation, auto, liability insurance (including self-insurance) or no fault insurance settlement provides dollars for future medicals, Medicare and the American taxpayer should not be billed for the same items, services and expenses. It's not about MSA "requirements" or settling cases to avoid CMS workload review thresholds. It's about extending the life of the Medicare Trust Funds so that the federal insurance program will be available for everyone when the time is right.
Why All The Confusion?
For years, too many parties resolving insurance claims involving medical expenses have relied on non-legal third party MSA vendors for their "legal" interpretation of the MSP Act. Those vendors have missed the forest for the trees. The law is what it is, and the statutory text trumps all. When trying to comply with federal law, doesn't it make sense to hire a lawyer who has experience with the subject matter in question instead of a nurse, a case examiner or some other analyst?