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The Medicare Secondary Payor Act opened a new opportunity for nurses. FIG will give
you the proper training to take full advantage of this expanding area and assist with safeguarding funds to properly care for injured/ill clients.
In 1980, Congress created the Medicare Secondary Payor Act (MSP) in an effort to slow the rising cost of Medicare. The MSP prohibited Medicare from paying for medical treatment that was also covered by other insurers (workers’ compensation, liability, automobile, no-fault, or employer insurance). In these instances, Medicare becomes the ‘secondary payor’ for medical care. Between 1991 and 1998, Medicare paid nearly $40 billion for medical care in workers’ compensation cases where Medicare was the secondary payer. Medicare demands that their interest be taken into consideration when settling cases where the settlement funds include payment for future medical care. If not, Medicare can take legal action to recover funds and the Medicare benefits can be negatively impacted in the future. In certain cases, Medicare strongly recommends compliance of future related Medicare allowable medical care be set-aside from the settlement funds and Medicare to review/approve the adequacy of the amount. This is the conception of a Medicare Set-Aside (MSA). The MSA Allocation is a detailed report which determines future medical care and what is acceptable/covered by Medicare. During the settlement process, it is imperative that you understand when and how the case should be evaluated to assure Medicare’s interest has been taken into consideration.
The Medicare Set-Aside (MSA) education courses (30 hours, 16 hours, or 5 hours) have been pre-approved by the International Commission on Health Care Certification (ICHCC) as meeting the educational requirements necessary to sit for the Medicare Set-Aside Consultant Certified (MSCC) exam or maintain the MSCC credentials.
The Medicare Set-Aside (MSA) Education Courses are taught from a medical perspective. You will receive
an overview of Medicare as well as an understanding of the Medicare Set-Aside process. You will learn
how to request, organize and review medical records that are pertinent to the MSA process. You will
learn how to effectively communicate with health care providers and determine future medical care to
be included in the MSA report. You will learn how to identify Medicare’s coverage and the appropriate
costs for future medical care. You will learn how to finalize the MSA report and submit to the Centers for
Medicare and Medicaid Services (CMS) for their review/response. You will also learn how to effectively
communicate the MSA recommendations for a smooth transition to funding and administration of the
MSA. These objectives will be taught through independent study, recorded webinar series, and hands-on
application through the completion of a MSA Sample report. You will learn practical skills and utilize
hands-on teaching techniques to effectively learn the MSA process. Completion of the MSA Courses allows the designation of MSA Allocator/Consultant and eligibility to obtain/maintain credentialing.
Please visit ICHCC’s website for details regarding the MSCC certification or renewal criteria (chcc1.
org).
There are 3 options for the Medicare Set-Aside (MSA) courses:
All 3 options of the MSA courses are taught via a recorded webinar and homework assignment. The student will be provided with instructions, webinar recording(s), and homework assignment(s) on CD/DVD through the US mail or electronic downloading. In an effort to be a good steward of the earth, a printed/hard copy of the course materials will not be provided. All course materials are provided in an electronic version. The student has the option to print the course materials or view in an electronic version. To promote the learning environment, students are encouraged to contact the Instructor with questions/comments during the course.
Option 1 (full MSA course): This MSA education course provides 30 contact hours of education and consists of three components. (Cost is $999)
Component 1: Pre-webinar home study (4 hours)
The Pre-webinar home study is an independent component of reviewing designated Medicare information
(CMS) and answering a questionnaire. The Pre-webinar home study gives a general overview of
Medicare, identifies key words/phrases in the MSA process, and prepares you for the MSA
webinar.
Component 2: MSA webinar (16 hours)
The MSA webinar component is a recorded session. Rather than sitting in a classroom setting,
you have the convenience/comfort of sitting in front of your computer at work or home. A recorded
webinar is cost effective by eliminating airfare, travel, hotel, and meal costs. Expenses related to a
classroom setting averages $1,000 - $2,000. A recorded webinar also reduces time away from work and
family. The recorded webinar allows you to view the slide presentation and listen to the audio from the
Instructor. You will be able to pause, fast forward, and rewind the recorded webinar - to learn at your
own pace. Homework assignments will be given at the end of each section to assure you are on target
with the learning process. You will also be able to email/call the Instructor with questions or comments.
Component 3: Post-webinar home study (10 hours)
The Post-webinar home study is an independent component of completing of an MSA Sample report. A
case scenario will be presented in the course materials and instructions will be provided for completion
of the MSA Sample report. The MSA Sample report will be peer reviewed by an MSA Instructor.
Option 2 (refresher course): CMS does not acknowledge the formal certification process to complete/submit an MSA report. Some choose this option to learn the MSA process without proceeding with certification. Others choose this option as a refresher course if they have not practiced within the field and are in need of CMS updates to the MSA process. This MSA Education Course provides 16 contact hours of education and consists of the recorded webinar and homework assignment. This MSA education course only includes component 2 - the MSA webinar and homework assignments. (Cost is $599)
Option 3 (renewal course): Once MSCC certified, ICHCC requires a minimum of 5 contact hours specific to the MSA process for renewal. Some choose this option for updates to the MSA process since initial certification. This MSA Course provides 5 contact hours of education and consists of the recorded webinar and homework assignment. (Cost is $199)
