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:
LIABILITY MEDICARE SET-ASIDE ARRANGEMENT (LMSA)
PERSONAL CERTIFICATION OF COMPLETED TREATMENT
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


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