Medicare Set Asides

To reduce Medicare Set Asides (MSAs): 

  • Use a Cost-Benefit Analysis to determine how far you are willing to go.
    • Check for generic vs. brand name medications and patent expiration dates.
    • Can the recommended treatment be eliminated by arguing the applicant is not a good candidate for that treatment?
    • Use applicant’s testimony to your advantage (“none of the treatment has been helpful”).
    • Argue future treatment is too speculative and unlikely if applicant complies with the work restrictions.