Spending MSA Funds out of the Country

Posted by John Cattie

Question:
I have an MSA question regarding WC. Is it appropriate for our client to spend her MSA funds for related medical care while out of the country, specifically, Greece? Your thoughts would be greatly appreciated.

Answer:
Great question! To my knowledge, CMS has not shared with the general public whether it is appropriate to spend MSA proceeds outside the US versus inside the US. Medicare’s concern is that its future interest is being protected. We know that the only approved use of MSA proceeds is to pay for future injury-related care otherwise payable by Medicare. There are two notable exceptions – any bank charges or postage can be paid out of the MSA. Since we know what MSA proceeds should be spent on, my thought is this: if the expenses being paid out of the country are 1) injury-related and 2) otherwise payable by Medicare, then so long as annual accountings are being kept and it can be shown that the proceeds spent abroad were indeed for injury-related care otherwise payable by Medicare, then the expenditures are proper. The location these proceeds are spent should have no bearing on whether the expenditures were appropriate. I hope this sheds some light on the situation.

My best,
John Cattie