CMS has issued specific guidelines that address the proper administration of a
Medicare Set Aside (MSA) account. The guidelines require that the MSA funds only be used
for injury-related Medicare-covered treatment and Medicare-covered pharmacy expenses.
Certain costs such as document copying charges, mailing fees/postage, banking fees related
to the account and income tax on interest income from the MSA may be paid from the MSA
account. In addition, the funds must be kept in a separate interest bearing account with
annual attestation through the depletion of the MSA account.
Funding for the MSA may be made by a lump-sum payment or through a structured
settlement annuity. If a structured settlement is proposed, the initial deposit or “seed”
amount must include the cost of the first surgical procedure and first replacement, if any
(e.g., pain pump or spinal cord stimulator). The first two years of annual payments are also
added to the seed. If the MSA was funded by a structure, excess funds must be carried
forward in the account. Should the structured MSA account be exhausted prematurely in
any given year, CMS should pay for additional injury-related medical expenses during the
year, provided that the claimant is on Medicare. The MSA account may be selfadministered,
self-administered with support services or professionally administered by a
Bridge Pointe’s MSP debit card, available through the self-administration with
support program, simplifies the proper administration of the MSA account. This free
pharmacy and medical debit card provides discounts for injury-related Medicare covered
drugs and tracks medical expenses for greater ease in the annual attestation reporting
required by CMS. The MSP debit card may be used like any traditional debit card to pay for
injury-related Medicare covered treatment from the MSA account at the time of service.
Additional details about the MSP debit card are available upon request.