Medicare Set-aside Certified Consultant (MSCC)
For the convenience of the reader, this Certified page provides links to pages pertinent to the MSCC credential. You will find direct access links to the MSCC application page, the MSCC examination page, the MSCC recertification page, and the MSCC Listing. Please click on the appropriate menu button for the item you need.
The Medicare Set-aside Consultant Certified (MSCC) credential is designed to identify those professionals who work within the workers' compensation benefit system as either a health care professional, legal representative, or as an insurance claims adjuster, who have achieved specific pre-approved training in Medicare set-aside trust arrangements, and have demonstrated a breadth of knowledge regarding the development and application of the Medicare set-aside trust arrangement process. Additionally, this credential is designed to express to the consumer that the person holding the MSCC credential has agreed to come under the scrutiny of a certifying review board (CHCC), to be peer reviewed, and to adhere to a set of standards governing ethics and professional behaviors.
Qualifying for the Medicare Set-aside Certified Consultant (MSCC) credential is based upon one's primary career experience in one of the following areas of expertise and career focus, but not limited to:
- workers' compensation case management
- medical case management for work-related injuries
- legal case management with work-related injury claims
- insurance benefit case management
- social services case management of injured workers
- rehabilitation case management and/or direct-service care of worker's compensation recipients
- case management of medicare beneficiaries
The International Commission on Health Care Certification's definition of "Qualified Health Care Professional" does not apply to this credential due to the lack of case management involvement and case management applications to medicare set-aside allocations or trusts. For those who are interested, the "Qualified Health Care Professional" definition and a listing of its criteria are detailed in the ICHCC Standards and Guidelines Manual available for download o n the home page of this web site. All certification candidates should have this manual in his or her library regardless of the non-application of the Qualified Health Care Professional definition.
The ICHCC requires the following criteria to be met by all candidates in order to qualify to sit for the examination:
Professional Experience: A minimum of 12 months of acceptable full time employment within the past 3 years in any of the following industry disciplines is required. Acceptable employment means that the candidate is working within the Workers’ Compensation or Liability insurance industry. Educational requirements require a minimum of an Associate's Degree in a related field effective January 2, 2014.
Insurance Claims Adjusters
License/Certification Requirement: *see license requirement
License/Certification Requirement: License to practice law
Life Care Planners
License/Certification Requirement: Certified Life Care Planner (CLCP) or Certified Nurse Life Care Planner (CNLCP)
License/Certification Requirement: Certified Case Manager (CCM)
Disability Management Professionals
License/Certification Requirement: Certified Disability Management Specialist (CDMS) or Certified Disability Examiner (CDE)
License/Certification Requirement: Certified Rehabilitation Counselor (CRC), Certified Rehabilitation Registered Nurse (CRRN)
License/Certification Requirement: Registered Nurse (RN) or Licensed Practical Nurse/Licensed Vocational Nurse (LPN/LVN)
It is a requirement that the candidate has one of the licenses or certifications listed under Professional Experience, License /Certification Requirement and that the license or certification is current and the candidate is in good standing with his or her professional discipline.
**In regards to Claims Adjusters, licensing requirements vary by state. In some States, claims adjusters employed by insurance companies can work under the company license and need not become licensed themselves. Adjusters will need to provide proof the appropriate State-defined requirements are met.
The Medicare Set-aside Certified Consultant professional must have his or her MSCC credential renewed every 3 years. To maintain the use of the MSCC professional designation, the MSCC certificant is required to provide proof of 15 CEUS acquired over the certification period. Within the 15 required CEUs, at least 5 must be of ethical practice subject matter. The remaining CEUs can be of course topics related to MSAs or the certificant's area of expertise.
Options for Renewal
Options for renewal are the same as they are for the CLCP/CCLCP credentials, and include:
- Option One: Documentation of 15 CEUs
- Option Two: Re-examination
Submit verification of 15 CEUs acquired during the certification period. If a course was preapproved, the MSCC professional only needs to provide the attendance verification form. The fee is $250.
If the MSCC professional attended a program that was not approved for MSCC CEUs, the required documentation must be submitted and is subject to review. This includes the attendance verification and course agenda. The renewal fee increases to $300 for any number of non-preapproved CEUs submitted with the renewal application.
Re-examination. The fee is $425 and covers both the examination fee and certification renewal.
If the MSCC certificant does not desire to retest, but also lacks the necessary 15 CEUs, then the candidate can apply for an extension. This is available to MSCCs who have completed and submitted 5 of the 15 CEUs required for maintenance. A six (6) month extension may be granted. The fee is $100.
Executive Board of Commissioners
- Amy Bilton, JD, MSCC, CMSP-F
- Leta Sharkey, MS, NCC, CDMS, CRP, CLCP, MSCC
- Debbie Cragen, RN, MSN, ANP-BC, NP-C, CLNC, CLCP, MSCC
- Carol O'Quinn, RN, CLNC, CLCP, MSCC
- Jennifer Santoro, JD, MSCC
- Patricia Smith, RN, BSN, MSCC, CDMS, CLCP