Liability Medicare Set-Aside Arrangement

Many physicians who treat patients on crossover personal injury/Medicare cases may have some knowledge or the Liability Medicare Set-Aside Arrangement (LMSA).

Medicare has a issued the following memorandum which deals with the simplification of the LMSA process:


Your certification can serve to expedite the resolution of these crossover personal injury/Medicare cases.  The following is a Physician Certification Form that your office can use to supply your LMSA Certification to the patient, the patient’s attorney or any first or third-party insurance carrier.  If you receive a Certification Request from an attorney when he requests your medical records and bills, you should not be surprised. We recommend a simple certification such as that below:


I, (Name of Physician), treated (Patient’s Name), for injuries which the patient has received proceeds from liability insurance (including self-insurance), settlements, judgment, awards, or other settlements, that he/she sustained in an accident that occurred on (Date  of Accident).

I do hereby certify that treatment for these injuries has been completed as of the date of the settlement, and that future medical items and/or services for these injuries will not be required.

Pursuant to NRS 53.045, I declare under penalty of perjury that the foregoing is true and correct.

_________________________________        _____________________________________
DATE                                                                                     PHYSICIAN

This entry was posted on Monday, September 24th, 2012 at 8:00 am and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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