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Medicare Set-Aside

Marshall Dennehey Warner Coleman & Goggin has a designated practice group to handle Medicare set-asides and has been in the forefront of handling the issues associated with Medicare set-asides since the development of Medicare's regulation in 2001. We have reviewed over 1,600 cases and obtained Medicare approval in over 1,500 of those cases. From its inception, this group has been led by James E. Pocius who was actively involved in the creation and refinement of the regulations.
This field has become increasingly complicated over the years. When the Center for Medicare Set-Asides (CMS) initially promulgated the regulations regarding set-asides, it was not known how these cases would be handled. Fortunately for our clients, Jim and his group regularly advise and counsel insurance companies, employers and self-insureds on how to seek creative solutions to the complex problems created by Medicare set-asides. In addition to authoring numerous articles on this subject, Jim frequently speaks at seminars, conferences and webinars at the national and local levels.
The Medicare practice is structured to provide the client with prompt and effective service. Medicare approval can take eight to 10 weeks once all the proper information has been submitted to the Center for Medicare Set-Asides. Our clients work with one attorney for the life of a case. There is no turn-over in the middle of a case, and if updates are needed, the same person who prepared the original estimate for Medicare will prepare the update. In this way, we ensure continuity. Furthermore, the handling attorney is available for questions and advice throughout the pendency of the case.
Our attorneys possess the comprehensive knowledge  necessary to effectively handle set-asides. We are well-versed in the workings of the federal and state liability systems, as well as the workers' compensation systems of various states. In addition, we are experienced in protecting Medicare's interest, the State Children's Health Insurance Program (SCHIP) Reporting Law and Medicare Set-Asides. Based upon this knowledge, we offer cogent advice regarding case settlements as well as the use of structured settlements and other strategies to bring cases to a successful conclusion. Further, we are accustomed to working with lawyers in various localities and providing them with the support they need regarding Medicare issues.
Not only do we have the knowledge and experience to assist you with your Medicare problems, we also provide these services on a very cost-effective basis.
National Medicare Services Provided:

  • Medicare set-aside allocations for workers' compensation and liability cases
  • Medicare eligibility search
  • Medicare submission to the agency for approval
  • Advice and consultation including attending mediations, working with your defense counsel, preparing and reviewing necessary documents, answering questions on specific cases, preparing Medicare paragraphs for settlement documents
  • Conditional payment searches
  • Revision of Medicare set-aside allocations
  • Rush services

The members of our Medicare Set-Aside Practice Group are available to speak with you to help you find the right strategies to achieve your goals. 

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James E. Pocius
Chair, Medicare Set-Aside Practice Group
(570) 496-4601


Niki T. Ingram
Director, Workers' Compensation Department
(215) 575-2704
Ross A. Carrozza
(570) 496-4617

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