Personal Injury Claims Settlement: New CMS Guidance

Navigating Clarifications to Medicare Set-Asides, QSFs and Section 111 Reporting Requirements

CMS alerts and memorandum issued Sept. 30

Recording of a 90-minute CLE webinar with Q&A

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Conducted on Tuesday, December 6, 2011

Recorded event now available

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Course Materials

This CLE course will prepare personal injury attorneys to handle legal challenges that new CMS guidance raises for Liability Medical Set-Aside Arrangements; meeting reporting requirements for settlements involving Qualified Set-Aside Funds and exposure claims; and complying with Section 111 reporting timelines.


On Sept. 30, 2011, CMS issued several important alerts and memorandum impacting liability settlements involving Medicare beneficiaries. Counsel for both plaintiffs and defendants must comply with the new guidance to protect Medicare’s interest in personal injury settlements and avoid MSP liability.

For the first time, CMS addressed Liability Medical Set-Aside Arrangements (LMSAs). Counsel resolving claims for Medicare beneficiaries must now develop a formal process for reviewing LMSA issues in the settlement process. Many questions regarding LMSA review by CMS remain unanswered.

CMS also announced important new clarifications of reporting requirements. Counsel must meet the obligations to report Qualified Set-Aside Funds payments and payments made for exposure, ingestion and implantation claims. The Section 111 mandatory reporting obligation timeline was also significantly revised.

Listen as our authoritative panel of personal injury attorneys discusses best practices for crafting effective personal injury settlements to comply with the new guidance and explores ways to handle the issues left unresolved by the guidance.



  1. Medicare Set-Asides
    1. Overview of Medicare set-asides
    2. Requirements of the CMS guidance
    3. Addressing LMSAs in a settlement
  2. Qualified Settlement Funds
    1. Overview of QSF payments
    2. Clarification of reporting requirements
  3. Exposure, ingestion and implantation Claims
    1. History of conditional payments for these claims
    2. Updated guidance for compliance with MSP
  4. Section 111 Reporting
    1. Overview of reporting requirement
    2. Revised timeline for reporting compliance
  5. Additional CMS Announcements


The panel will review these and other key questions:

  • When is an LMSA not required and what certification is needed to avoid one?
  • What are the reporting requirements for payments made pursuant to settlement of exposure, ingestion and implantation claims?
  • When is reporting required for payments made by a QSF to comply with the MSP?
  • What is the new timeline for electronic reporting requirements of Section 111?

Following the speaker presentations, you'll have an opportunity to get answers to your specific questions during the interactive Q&A.


Jeremy T. Burton
Jeremy T. Burton

Williams Montgomery & John

He is a partner and a member of the firm's Product Liability and Tort Defense Practice Groups. He focuses his...  |  Read More

John Cattie
John Cattie
Head, Future Cost of Care Practice
Garretson Group

He heads the Future Cost of Care Practice. In this role, he counsels attorneys nationwide with respect to Medicare...  |  Read More

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