The Centers for Medicare and Medicaid Services (CMS) is tasked with approving future medical plans in settlements for workers’ compensation claims of Medicare beneficiaries or those who will soon become Medicare eligible.

You may have asked that question lately. In the management of workers’ compensation claims, Utilization Review (UR) provides a process whereby proposed treatment is assessed for medical necessity and reasonableness.

CMS will consider a proposed Medicare Set-Aside (MSA) when the Total Settlement Amount (TSA) exceeds the one of two review thresholds.