Medicaid Analysis & Forecasting
UFS is the only settlement planning firm with the ability to provide a detailed forecast of a plaintiff's likely Medicaid benefits and integrate the results into a comprehensive financial plan.
Why Medicaid Forecasting is Important
In many cases involving serious personal injury, the plaintiff will be eligible for Medicaid benefits. Predicting with reasonable accuracy the level of benefits for which an injured party will be eligible can be critical to the optimal structuring of complex personal injury case settlements.
Often, it is advisable to have the bulk of the settlement proceeds go into a Special Needs Trust (SNT) to ensure that the client's Medicaid eligibility is maintained. To determine the optimal investment strategy for these cases, it is first necessary to identify the potential value of Medicaid benefits if they are preserved and received over the client's life expectancy. Putting a number on these benefits requires a detailed determination of what services are necessary, what they will cost, and to what extent they are likely to be covered under Medicaid.
Step I: Forecasting Medicaid benefits for an injured plaintiff starts with the vocational rehabilitation specialist report, also known as the Life Care Plan, which outlines the client's anticipated future needs. These needs may be related to medical treatment, special equipment, modifications to the home, diet, transportation and many other factors.
Step II: Once the Life Care Plan is complete, the next step is to have it reviewed by an economist, who determines an expected cost for each component of the Plan, taking into account inflation over the client's life expectancy. These calculations are then used as a basis for determining the present value of each of these services.
Step III: Finally, it is necessary to determine the extent to which these services may be covered by Medicaid. UFS will take the economist's report and perform a detailed analysis of how the identified costs match up against specific Medicaid billing codes. We will assess the client's eligibility for each required service, the reimbursement rate that applies, and provide the attorney with a best estimate of what portion of the client's future needs will be covered by Medicaid. This information is invaluable for attorneys seeking to estimate the client's remaining need after Medicaid in order to develop a sound settlement strategy.
An Information Edge for Recipients
In addition, UFS provides attorneys and clients with a reference tool that enables them to access online the detail with respect to how stated Medicaid reimbursement rates apply to each service for which the client is eligible. This information remains available to plaintiffs post-settlement and - importantly - is automatically updated to reflect changes in reimbursement rates. In this way, UFS provides a critical information edge to individuals seeking to ensure that they receive the full extent of applicable benefits.