Medicare set-aside companies request Medicare and benefit entitlement information from our records to assist insurance carriers, third party administrators, self-insured companies, and attorneys in complying with Medicare Secondary Payer (MSP) laws. MSP laws protect Medicare’s interests in workers’ compensation settlement cases. Medicare set-aside companies use the information they request to help Medicare determine settlement amounts in cases involving future medical and drug-related expenses. We may only disclose information to Medicare set-aside companies with proper consent.

We consider requests from Medicare set-aside companies as non-program related requests. Therefore, we must charge and collect fees prior to disclosing any information. Some companies may insist that the requested information relates to administering Medicare or workers’ compensation programs. Nonetheless, Medicare or worker’s compensation programs are third party private commercial entities, which are not directly responsible for administering health and income maintenance programs under the Social Security Act. Medicare set-aside companies act as advocates for attorneys, carriers, and claimants in coordinating workers’ compensation and Social Security, Medicare, and Medicaid benefits. As such, we must charge and collect fees for providing the requested information.

See GN 03311.005 for additional information on charging fees for record requests.

We do not provide queries of any type, including third party queries (TPQY), for requests from Medicare set-aside companies. Medicare set-aside companies usually request limited data.