,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #aihb  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,may #ae1 #bjac ,mr4  
,rei*]t 7= himself & ,mr4 ,?ompson (    
,cali=nia7 introduc$ ! foll[+ bill2 :i* 
0 ref]r$ to ! ,committee on ,ways &     
,means1 & 9 addition to ! ,committee on 
,en]gy & ,comm]ce1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d section    
#ahfb ( ! ,social ,security ,act )      
respect to ! application ( ,m$ic>e      
second>y pay] rules to work]s'          
comp5sation settlem5t agreem5ts &       
,m$ic>e set-asides "u su* agreem5ts4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,m$ic>e ,second>y ,pay] & ,work]s'    
,comp5sation ,settlem5t ,agreem5ts ,act 
( #bjac4  #b4 ,application ( ,m$ic>e    
second>y pay] rules to c]ta9 work]s'    
comp5sation settlem5t agreem5ts &       
qualifi$ ,m$ic>e set-aside provisions   
7a7 ,?re%old = second>y pay] provisions 

= c]ta9 work]s' comp5sation settlem5t   
agreem5ts ,section #ahfb ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #aciey7 is
 am5d$--  7#a7 9 subsection             
7b77#b77;,a77ii71 by ins]t+ subject to  
subsection 7p71 aft] 7ii72 &  7#b7 by   
add+ at ! end ! foll[+ new subsection3  
7p7 ,?re%old = second>y pay] provisions 
= c]ta9 work]s' comp5sation settlem5t   
agreem5ts  7#a7 ,9 g5]al ,a work]s'     
comp5sation law or plan %all n be treat$
 z a prim>y plan = purposes ( subsection
 7b7 ) respect to a work]s' comp5sation 
settlem5t agreem5t if ! agreem5t 7or    
claimant "u ! agreem5t7 meets any ( !   
foll[+ requirem5ts3  7,a7 ,total        
settlem5t am\nt n exce$+ #be1jjj ,su*   
agreem5t has a total settlem5t am\nt 7z 
det]m9$ "u p>agraph 7#b77 t does n exce$
 #be1jjj or su* great] am\nt z !        
,secret>y may specify 9 regulations4    
7,b7 ,likely ineligibility ( work]s'    
comp5sation claimant = m$ic>e b5efits ,!
 claimant subject to su* agreem5t--  7i7
 is n eligible = b5efits "u ?is title z 

( ! effective date ( ! agreem5t2 &  7ii7
 is unlikely to become s eligible1 z    
det]m9$ "u p>agraph 7#c71 )9 #cj mon?s  
aft] su* effective date4  7,c7 ,no      
future work]s' comp5sation m$ical       
exp5ses ,! claimant subject to su*      
agreem5t is n eligible = paym5t ( m$ical
 exp5ses incurr$ aft] ! effective date (
 ! agreem5t f ! work]s' comp5sation law 
or plan ( ! jurisdiction 9 :i* su*      
agreem5t w be effective4  7,d7 ,no      
limitation on future work]s' comp5sation
 m$ical exp5ses ,su* agreem5t does n    
limit or ext+ui% ! "r ( ! claimant to   
paym5t ( m$ical exp5ses incurr$ aft] !  
effective date ( su* agreem5t by !      
work]s' comp5sation law or plan ( !     
jurisdiction 9 :i* ! agreem5t w be      
effective4  7#b7 ,det]m9ation ( total   
settlem5t am\nt ( work]s' comp5sation   
settlem5t agreem5t ,= purposes (        
p>agraph 7#a77;,a7 & subsection 7q7 & ) 
respect to a "w-relat$ injury or illness
 t is ! subject ( a work]s' comp5sation 
settlem5t agreem5t1 ! total settlem5t   

am\nt ( ! agreem5t is ! sum ( monet>y   
wage replacem5t b5efits1 attorney fees1 
all future m$ical exp5ses1 repaym5t (   
,m$ic>e conditional paym5ts1 pay\t      
totals = annuities to fund ! exp5ses    
li/$ above1 & any previ\sly settl$      
portion ( ! work]s' comp5sation claim4  
7#c7 ,det]m9ation ( likely ineligibility
 ( claimant = m$ic>e b5efits ,= purposes
 ( p>agraph 7#a77;,b77ii71 a work]s'    
comp5sation claimant %all be deem$      
unlikely to become eligible = b5efits "u
 ?is title )9 #cj mon?s aft] ! effective
 date ( ! agreem5t unless1 z ( !        
effective date ( ! agreem5t1 su*        
claimant is insur$ = disability         
insurance b5efits "u section            
#bbc7;c77#a7 & is describ$ 9 any ( !    
foll[+ subp>agraphs3  7,a7 ,aw>d$       
disability b5efits ,! individual has be5
 aw>d$ su* disability insurance b5efits4
  7,b7 ,appli$ = disability ,!          
individual has appli$ = su* disability  
insurance b5efits4  7,c7 ,anticipates   
appeal ,! individual has be5 d5i$ su*   

disability insurance b5efits b          
anticipates appeal+ t decision4  7,d7   
,appeal+ or refil+ ,! individual is 9 ! 
process ( appeal+ or refil+ = su*       
disability insurance b5efits4  7,e7     
,m9imum age ,! individual is at lea/ #fb
 ye>s & #f mon?s ( age4  7,f7 ,end-/age 
r5al disease ,! individual is m$ically  
det]m9$ to h end-/age r5al disease b    
does n yet qualify = heal? b5efits "u   
section #bbf;,a bas$ on su* disease4    
7#d7 ,def9itions ,= purposes ( ?is      
subsection & subsection 7q73  7,a7      
,compromise agreem5t ,! t]m compromise  
agreem5t means a work]s' comp5sation    
settlem5t agreem5t t--  7i7 applies to a
 work]s' comp5sation claim t is d5i$ or 
conte/$1 9 :ole or 9 "p1 by a work]s'   
comp5sation pay] involv$ "u ! work]s'   
comp5sation law or plan applicable to ! 
jurisdiction 9 :i* ! agreem5t has be5   
settl$2 &  7ii7 does n provide = a      
paym5t ( ! full am\nt ( b5efits s\ght or
 t may be payable "u ! work]s'          
comp5sation claim4  7,b7 ,commutation   

agreem5t ,! t]m commutation agreem5t    
means a work]s' comp5sation settlem5t   
agreem5t to settle all or a portion ( a 
work]s' comp5sation claim1 9 :i*--  7i7 
liability = pa/ & future b5efits is n   
disput$2 &  7ii7 ! p>ties to ! agreem5t 
agree to include paym5t = future work]s'
 comp5sation b5efits payable aft] ! date
 on :i* ! agreem5t becomes effective4   
7,c7 ,work]s' comp5sation claimant ,!   
t]m work]s' comp5sation claimant means a
 work] :o--  7i7 is or may be cov]$ "u a
 work]s' comp5sation law or plan2 &     
7ii7 submits a claim or accepts b5efits 
"u su* law or plan = a "w-relat$ injury 
or illness4  7,d7 ,work]s' comp5sation  
law or plan  7i7 ,9 g5]al ,! t]m work]s'
 comp5sation law or plan means a law or 
program adm9i/]$ by a ,/ate or ! ,unit$ 
,/ates to provide comp5sation to work]s 
= a "w-relat$ injury or illness 7or =   
disability or dea? caus$ by su* an      
injury or illness71 includ+ ! ,long%ore 
& ,h>bor ,work]s' ,comp5sation ,act 7#cc
 ,u4,s4,c4 #ija-idd1 #idh-iej71 *apt]   

#ha ( title #e1 ,unit$ ,/ates ,code     
7kn[n z ! ,f$]al ,employees ,comp5sation
 ,act71 ! ,black ,lung ,b5efits ,act    
7#cj ,u4,s4,c4 #ica et seq471 & "p ,c ( 
title #d ( ! ,f$]al ,coal ,m9e & ,safety
 ,act 7#cj ,u4,s4,c4 #ija et seq471 b n 
includ+ ! ,act ( ,april #bb1 #aijh 7#de 
,u4,s4,c4 #ea et seq47 7popul>ly ref]r$ 
to z ! ,f$]al ,employ]'s ,liability     
,act74  7ii7 ,inclusion ( simil>        
comp5sation plan ,su* t]m includes a    
simil> comp5sation plan e/abli%$ by an  
employ] t is fund$ by su* employ] or !  
insurance c>ri] ( su* employ] to provide
 comp5sation to a work] ( su* employ] = 
a "w-relat$ injury or illness4  7,e7    
,work]s' comp5sation pay] ,! t]m work]s'
 comp5sation pay] means1 ) respect to a 
work]s' comp5sation law or plan1 a      
work]s' comp5sation insur]1 self-insur]1
 employ]1 individual1 or any o!r entity 
t is or may be liable = ! paym5t (      
b5efits to a work]s' comp5sation        
claimant pursuant to ! work]s'          
comp5sation law or plan4  7,f7 ,work]s' 

comp5sation settlem5t agreem5t ,! t]m   
work]s' comp5sation settlem5t agreem5t  
means an agreem5t1 :i* includes a       
commutation agreem5t or compromise      
agreem5t1 or any comb9ation ( bo?1      
betwe5 a claimant & "o or m work]s'     
comp5sation pay]s :i*--  7i7 =ecloses ! 
possibility ( future paym5t ( "s or all 
work]s' comp5sation b5efits involv$2 &  
7ii7 7,i7 comp5sates ! claimant = a     
"w-relat$ injury or illness z provid$ = 
by a work]s' comp5sation law or plan2 or
  7,,ii7 elim9ates cause = litigation   
involv+ issues 9 dispute betwe5 !       
claimant & pay]4  4  7b7 ,satisfaction (
 second>y pay] requirem5ts ?r\gh use (  
qualifi$ m$ic>e set-,asides "u work]s'  
comp5sation settlem5t agreem5ts ,section
 #ahfb ( ! ,social ,security ,act 7#db  
,u4,s4,c4 #aciey71 z am5d$ by subsection
 7a71 is fur!r am5d$ by add+ at ! end ! 
foll[+ new subsection3  7q7 ,treatm5t ( 
qualifi$ ,m$ic>e set-,asides "u work]s' 
comp5sation settlem5t agreem5ts  7#a7   
,satisfaction ( second>y pay]           

requirem5ts ?r\gh use ( qualifi$ ,m$ic>e
 set-asides  7,a7 ,full satisfaction (  
claim obligations  7i7 ,9 g5]al ,if a   
work]s' comp5sation settlem5t agreem5t1 
relat$ to a claim ( a work]s'           
comp5sation claimant1 includes a        
qualifi$ ,m$ic>e set-aside 7z def9$ 9   
p>agraph 7#b771 su* set-aside %all      
satisfy any obligation ) respect to !   
pres5t or future paym5t reimbursem5t "u 
subsection 7b77#b7 ) respect to su*     
claim4 ,! ,secret>y %all h no fur!r     
rec\rse1 directly or indirectly1 "u ?is 
title ) respect to su* agreem5t4  7ii7  
,rule ( con/ruction ,no?+ 9 ?is section 
%all be con/ru$ z requir+ ! submission (
 a ,m$ic>e set-aside to ! ,secret>y4    
7,b7 ,m$ic>e set-aside & ,m$ic>e        
set-aside am\nt def9$ ,= purposes ( ?is 
subsection3  7i7 ,m$ic>e set-aside ,!   
t]m ,m$ic>e set-aside means1 ) respect  
to a work]s' comp5sation settlem5t      
agreem5t1 a provision 9 ! agreem5t t    
provides = a paym5t ( a lump sum1       
annuity1 a comb9ation ( a lump sum & an 

annuity1 or o!r am\nt t is 9 full       
satisfaction ( ! obligation describ$ 9  
subp>agraph 7,a7 = items & s]vices t !  
work]s' comp5sation claimant "u !       
agreem5t receiv$ or is likely to receive
 "u ! applicable work]s' comp5sation law
 & = :i* paym5t w\ld be made "u ?is     
title1 b = subsection 7b77#b77;,a74     
7ii7 ,m$ic>e set-aside am\nt ,! t]m     
,m$ic>e set-aside am\nt means1 ) respect
 to a ,m$ic>e set-aside1 ! actual doll> 
am\nt provid$ = 9 clause 7i74  7#b7     
,qualifi$ ,m$ic>e set-aside  7,a7       
,requirem5ts ( qualifi$ ,m$ic>e         
set-aside ,= purposes ( ?is subsection1 
! t]m qualifi$ ,m$ic>e set-aside is a   
,m$ic>e set-aside 9 :i* ! ,m$ic>e       
set-aside am\nt reasonably takes into   
acc\nt ! full paym5t obligation describ$
 9 p>agraph 7#a77;,a71 :ile meet+ !     
requirem5ts ( subp>agraphs 7,b7 & 7,c7 &
 giv+ due consid]ation to ! foll[+3  7i7
 ,! illness or injury giv+ rise to !    
work]s' comp5sation claim involv$4  7ii7
 ,! age & life expectancy ( ! claimant  

involv$4  7iii7 ,! reasonabl5ess ( &    
necessity = future m$ical exp5ses =     
treatm5t ( ! illness or injury involv$4 
7iv7 ,! duration ( & limitation on      
b5efits payable "u ! work]s' comp5sation
 law or plan involv$4  7v7 ,!           
regulations & case law relevant to !    
,/ate work]s' comp5sation law or plan   
involv$4  7,b7 ,items & s]vices includ$ 
,a qualifi$ ,m$ic>e set-aside--  7i7    
%all include paym5t = items & s]vices t 
are cov]$ & o!rwise payable "u ?is title
 z ( ! effective date ( ! work]s'       
comp5sation settlem5t agreem5t & t are  
cov]$ by ! work]s' comp5sation law or   
plan2 &  7ii7 is n requir$ to provide = 
paym5t = items & s]vices t are n        
describ$ 9 clause 7i74  7,c7 ,paym5t    
requirem5ts  7i7 ,requir$ use ( work]s' 
comp5sation fee s*$ule  7,i7 ,9 g5]al   
,except 9 ! case ( an optional direct   
paym5t ( a ,m$ic>e set-aside made "u    
p>agraph 7#e77;,a71 ! set-aside am\nt   
%all be bas$ ^u ! paym5t am\nt = items &
 s]vices "u ! work]s' comp5sation fee   

s*$ule 7effective z ( ! date ( !        
agreem5t7 applicable to ! work]s'       
comp5sation law or plan involv$4  7,,ii7
 ,work]s' comp5sation fee s*$ule def9$  
,= purposes ( ?is subsection1 ! t]m     
work]s' comp5sation fee s*$ule means1 ) 
respect to a work]s' comp5sation law or 
plan ( a ,/ate or a simil> plan         
applicable 9 a ,/ate1 ! s*$ule ( paym5t 
am\nts ! ,/ate has e/abli%$ to pay      
provid]s = items & s]vices furni%$ to   
work]s :o incur a "w-relat$ injury or   
illness z def9$ "u su* law or plan 7or 9
 ! abs5ce ( su* a s*$ule1 ! applicable  
m$ical reimbursem5t rate "u su* law or  
plan74  7ii7 ,optional proportional     
adju/m5t = compromise settlem5t         
agreem5ts  7,i7 ,9 g5]al ,9 ! case ( a  
compromise settlem5t agreem5t1 a        
claimant or work]s' comp5sation pay] :o 
is p>ty to ! agreem5t may elect to      
calculate ! ,m$ic>e set-aside am\nt ( ! 
agreem5t by apply+ a p]c5tage r$uction  
to ! ,m$ic>e set-aside am\nt = ! total  
settlem5t am\nt t c\ld h be5 payable "u 

! applicable work]s' comp5sation law or 
simil> plan involv$ _h ! d5i$ or conte/$
 portion ( ! claim n be5 subject to a   
compromise agreem5t4 ,! p]c5tage        
r$uction %all be equal to ! d5i$ or     
conte/$ p]c5tage ( su* total settlem5t4 
,su* election may be made by a p>ty to !
 agreem5t only ) ! writt5 cons5t ( ! o!r
 p>ty to ! agreem5t4  7,,ii7            
,application ,if ! claimant or work]s'  
comp5sation pay] elects to calculate !  
,m$ic>e set-aside am\nt "u ?is clause1 !
 ,m$ic>e set-aside %all be deem$ a      
qualifi$ ,m$ic>e set-aside4  7,d7 ,c]ta9
 ,m$ic>e set-asides ) safe h>bor am\nt  
deem$ qualifi$ ,m$ic>e set-asides  7i7  
,9 g5]al ,= purposes ( ?is section &    
subject to clause 7iv71 a ,m$ic>e       
set-aside ( a work]s' comp5sation       
settlem5t agreem5t %all be deem$ a      
qualifi$ ,m$ic>e set-aside if ! ,m$ic>e 
set-aside am\nt involv$ is ! safe h>bor 
am\nt = ! agreem5t & ! agreem5t does n  
exce$ #bej1jjj4  7ii7 ,writt5 cons5t ,a 
safe h>bor am\nt1 ) respect to a work]s'

 comp5sation agreem5t1 %all be treat$ z 
! ,m$ic>e set-aside am\nt = su* agreem5t
 = purposes ( clause 7i7 only ^u writt5 
cons5t ( all p>ties to ! agreem5t4      
7iii7 ,safe h>bor am\nt def9$ ,=        
purposes ( ?is subsection1 ! t]m safe   
h>bor am\nt means1 ) respect to a       
work]s' comp5sation settlem5t agreem5t1 
#ae p]c5t ( ! total settlem5t am\nt ( ! 
agreem5t 7z det]m9$ "u subsection       
7p77#b771 exclud+ repaym5t ( conditional
 paym5ts & previ\sly settl$ portions ( !
 claim involv$4 ,9 apply+ ! previ\s     
s5t5ce = purposes ( det]m9+ ! safe h>bor
 am\nt1 ) respect to a work]s'          
comp5sation agreem5t1 if ! agreem5t     
includes an annuity1 ! co/ 7b n ! pay\t 
( ! annuity7 %all be includ$ 9 det]m9+ !
 total settlem5t am\nt ( ! agreem5t4    
7iv7 ,m&atory direct paym5t ( safe h>bor
 am\nt ,a ,m$ic>e set-aside ( a work]'s 
comp5sation settlem5t agreem5t describ$ 
9 ?is p>agraph may n be treat$ z a      
qualifi$ set-aside "u clause 7i7 unless 
an election is made "u p>agraph         

7#e77;,a7 to transf] to ! ,secret>y a   
direct paym5t ( su* set-aside4  7,e7    
,secret>ial au?ority ) respect to deem$ 
qualifi$ ,m$ic>e set-asides ) safe h>bor
 am\nt  7i7 ,det]m9ation ,if ! ,secret>y
 det]m9es1 bas$ on ! data describ$ 9    
clause 7ii71 t ! provisions (           
subp>agraph 7,d7 h caus$ a significant  
negative f9ancial impact 7z specifi$ by 
! ,*ief ,actu>y ( ! ,c5t]s = ,m$ic>e    
,m$icaid ,s]vices7 on ! ,f$]al ,hospital
 ,insurance ,tru/ ,fund "u section #ahag
 or ! ,f$]al ,supplem5t>y ,m$ical       
,insurance ,tru/ ,fund "u section #ahda1
 !n ! ,secret>y %all adopt rules to     
r$uce su* impact by modify+ ! am\nt ( ! 
p]c5t describ$ 9 subp>agraph 7,d77iii74 
7ii7 ,requir$ data ,! det]m9ation "u    
clause 7i7 %all be bas$ on data on--    
7,i7 ! project$ effect ( ! provisions   
describ$ 9 su* p>agraph on ! ,f$]al     
,hospital ,insurance ,tru/ ,fund "u     
section #ahag or ! ,f$]al ,supplem5t>y  
,m$ical ,insurance ,tru/ ,fund "u       
section #ahda dur+ ! ?ree-ye> p]iod     

beg9n+ on ! date ( ! enactm5t ( ?is     
subsection2 z comp>$ to  7,,ii7 data on 
! effect on su* tru/ funds ( !          
provisions ( subsection 7b71 z 9 effect 
dur+ ! ?ree-ye> p]iod prior to su* date 
( enactm5t4  7#c7 ,process = approval ( 
qualifi$ m$ic>e set-asides  7,a7        
,optional prior approval by ,secret>y ,a
 p>ty to a work]s' comp5sation settlem5t
 agreem5t t includes a ,m$ic>e set-aside
 may submit to ! ,secret>y ! ,m$ic>e    
set-aside am\nt = approval ( ! set-aside
 z a qualifi$ ,m$ic>e set-aside4 ,!     
set-aside %all be submitt$ 9 accordance 
) a proc$ure specifi$ by ! ,secret>y4   
7,b7 ,notice ( det]m9ation ( approval or
 disapproval ,n lat] ?an #fj days aft] !
 date on :i* ! ,secret>y receives a     
submission "u subp>agraph 7,a71 !       
,secret>y %all notify 9 writ+ ! p>ties  
to ! work]s' comp5sation settlem5t      
agreem5t ( ! det]m9ation ( approval or  
disapproval4 ,if ! det]m9ation          
disapproves su* submission ! ,secret>y  
%all include ) su* notification !       

specific reasons = ! disapproval4 ,a    
det]m9ation t disapproves a submission  
is n valid if ! det]m9ation does n      
include a specific explanation ( ea*    
defici5cy ( ! submission4  7#d7 ,appeals
  7,a7 ,9 g5]al ,a p>ty to a work]s'    
comp5sation settlem5t agreem5t t is     
dissatisfi$ ) a det]m9ation "u p>agraph 
7#c77;,b71 ^u fil+ a reque/ =           
reconsid]ation ) ! ,secret>y n lat] ?an 
#fj days aft] ! date ( notice ( su*     
det]m9ation1 %all be entitl$ to--  7i7  
reconsid]ation ( ! det]m9ation by !     
,secret>y 7) respect to su*             
det]m9ation72  7ii7 a he>+ be=e an      
adm9i/rative judge !reon aft] su*       
reconsid]ation2 &  7iii7 judicial review
 ( ! ,secret>y's f9al det]m9ation aft]  
su* he>+4  7,b7 ,deadl9es = decisions   
7i7 ,reconsid]ations  7,i7 ,9 g5]al ,!  
,secret>y %all conduct & conclude a     
reconsid]ation ( a det]m9ation "u       
subp>agraph 7,a77i7 & mail ! notice ( ! 
decision ( su* reconsid]ation to ! p>ty 
involv$ by n lat] ?an ! la/ day ( !     

#cj-;day p]iod beg9n+ on ! date t a     
reque/ = su* reconsid]ation has be5     
timely fil$4  7,,ii7 ,appeals (         
reconsid]ations ,if a p>ty to ! work]s' 
comp5sation settlem5t involv$ is        
dissatisfi$ ) ! ,secret>y's decision "u 
subclause 7,i7 t p>ty may file an appeal
 )9 ! #cj-;day p]iod aft] ! date (      
receipt ( ! notice ( ! decision "u su*  
subclause & reque/ a he>+ be=e an       
adm9i/rative law judge4  7,,iii7        
,failure by secret>y to provide notice  
,9 ! case ( a failure by ! ,secret>y to 
mail ! notice ( ! decision "u subclause 
7,i7 by ! la/ day ( ! p]iod describ$ 9  
su* subclause1 ! ,secret>y %all be deem$
 to h approv$ ! submission z submitt$ "u
 p>agraph 7#c77;,a74  7ii7 ,he>+s  7,i7 
,9 g5]al ,an adm9i/rative law judge %all
 conduct & conclude a he>+ on a decision
 ( ! ,secret>y "u clause 7i7 & r5d] a   
decision on su* he>+ by n lat] ?an ! la/
 day ( ! #ij-;day p]iod beg9n+ on ! date
 t a reque/ = su* he>+ has be5 timely   
fil$4  7,,ii7 ,judicial review ,a       

decision "u subclause 7,i7 by an        
adm9i/rative law judge con/itutes a f9al
 ag5cy action & is subject to judicial  
review4  7,,iii7 ,failure by            
adm9i/rative law judge to r5d] timely   
decision ,9 ! case ( a failure by an    
adm9i/rative law judge to r5d] a        
decision "u subclause 7,i7 by ! la/ day 
( ! p]iod describ$ 9 su* subclause1 !   
p>ty reque/+ ! he>+ may seek judicial   
review ( ! decision "u clause 7i71      
not)/&+ any requirem5ts = a he>+ =      
purposes ( ! p>ty's "r to su* judicial  
review4  7#e7 ,adm9i/ration ( m$ic>e    
set-aside provisions2 protection f c]ta9
 liability  7,a7 ,optional direct paym5t
 ( m$ic>e set-aside am\nt  7i7 ,election
 = direct paym5t ( m$ic>e set-aside ,)  
respect to a claim = :i* a work]s'      
comp5sation settlem5t agreem5t is       
e/abli%$1 a claimant or work]s'         
comp5sation pay] :o is p>ty to !        
agreem5t may elect1 b is n requir$1 to  
transf] to ! ,secret>y a direct paym5t (
 ! qualifi$ ,m$ic>e set-aside4 ,)       

respect to a qualifi$ ,m$ic>e set-aside 
paid directly to ! ,secret>y1 ! p>ties  
involv$ may calculate ! ,m$ic>e         
set-aside am\nt ( su* set-aside us+ any 
( ! foll[+ me?ods3  7,i7 ,9 ! case ( any
 ,m$ic>e set-aside ( a compromise       
settlem5t agreem5t "u p>agraph          
7#b77;,c77ii71 ! am\nt calculat$ 9      
accordance ) su* p>agraph4  7,,ii7 ,9 ! 
case ( any ,m$ic>e set-aside1 ! am\nt   
bas$ ^u ! paym5t am\nt = items & s]vices
 "u ! work]s' comp5sation fee s*$ule    
7effective z ( ! date ( ! agreem5t7     
applicable to ! work]s' comp5sation law 
or plan involv$1 9 accordance ) p>agraph
 7#b77;,c77i77,i74  7,,iii7 ,9 ! case ( 
any ,m$ic>e set-aside1 ! paym5t am\nt   
applicable to ! items & s]vices "u ?is  
title z 9 effect on ! effective date ( !
 agreem5t4  ,su* transf] %all be 9      
accordance ) a proc$ure e/abli%$ by !   
,secret>y & %all be made only ^u writt5 
cons5t ( ! o!r p>ty to ! agreem5t4  7ii7
 ,election satisfy+ liability ,an       
election made "u clause 7i71 ) respect  

to a qualifi$ ,m$ic>e set-aside %all    
satisfy any paym5t1 9 relation to !     
und]ly+ claim ( ! relat$ work]s'        
comp5sation settlem5t agreem5t1 requir$ 
"u subsection 7b77#b7 to be made by !   
claimant or pay] to ! ,secret>y4 ,!     
,secret>y %all h no fur!r rec\rse1      
directly or indirectly1 "u ?is title )  
respect to su* agreem5t4  7,b7          
,protection f c]ta9 liability  7i7      
,liability = m$ic>e set-aside paym5t    
great] ?an paym5t "u work]s' comp5sation
 law ,no work]s' comp5sation claimant1  
work]s' comp5sation pay]1 employ]1      
adm9i/rator ( ! ,m$ic>e set-aside1 legal
 repres5tative ( ! claimant1 pay]1      
employ]1 or adm9i/rator1 or any o!r p>ty
 relat$ to ! claimant1 pay]1 employ]1 or
 adm9i/rator %all be liable = any paym5t
 am\nt e/abli%$ "u a ,m$ic>e set-aside =
 an item or s]vice provid$ to ! claimant
 t is great] ?an ! paym5t am\nt = ! item
 or s]vice e/abli%$ "u ! work]s'        
comp5sation fee s*$ule 7or 9 ! abs5ce ( 
su* s*$ule1 ! m$ical reimbursem5t rate7 

"u ! comp5sation law or plan ( !        
jurisdiction :]e ! agreem5t w be        
effective4  7ii7 ,liability = provid]   
*>ges great] ?an paym5t "u work]s'      
comp5sation agreem5t ,) respect to a    
work]s' comp5sation settlem5t agreem5t1 
a provid] may n bill 7or collect any    
am\nt f7 ! work]s' comp5sation claimant1
 work]s' comp5sation pay]1 employ]1     
adm9i/rator ( ! ,m$ic>e set-aside1 legal
 repres5tative ( ! claimant1 pay]1      
employ]1 or adm9i/rator1 or any o!r p>ty
 relat$ to ! claimant1 pay]1 employ]1 or
 adm9i/rator an am\nt = items & s]vices 
provid$ to ! claimant t is great] ?an ! 
paym5t rate = su* items & s]vices       
e/abli%$ "u ! ,m$ic>e set-aside ( !     
agreem5t4 ,no p]son is liable = paym5t (
 any am\nts bill$ = an item or s]vice 9 
violation ( ! previ\s s5t5ce4 ,if a     
provid] willfully bills 7or collects an 
am\nt7 = su* an item or s]vice 9        
violation ( su* s5t5ce1 ! ,secret>y may 
apply sanctions aga9/ ! provid] 9       
accordance ) section #ahdb7;j77#b7 9 !  

same mann] z su* section applies )      
respect to a physician4 ,p>agraph 7#d7 (
 section #ahdb7;j7 %all apply "u ?is    
clause 9 ! same mann] z su* p>agraph    
applies "u su* section4  7#f7 ,treatm5t 
( ,/ate work]s' comp5sation law ,=      
purposes ( ?is subsection & subsection  
7p71 if a work]s' comp5sation settlem5t 
agreem5t is accept$1 review$1 approv$1  
or o!rwise f9aliz$ 9 accordance ) !     
work]s' comp5sation law ( ! jurisdiction
 9 :i* su* agreem5t w be effective1 su* 
acceptance1 review1 approval1 or o!r    
f9alization %all be deem$ conclusive z  
to any & all matt]s )9 ! jurisdiction ( 
! work]s' comp5sation law1 includ+ !    
det]m9ation ( reasonabl5ess ( !         
settlem5t value2 any allocations (      
settlem5t funds2 ! projection ( future  
indemnity or m$ical b5efits t may be    
payable "u ! ,/ate work]s' comp5sation  
law2 &1 9 ! case ( a compromise         
agreem5t1 ! total am\nt t c\ld h be5    
payable = a claim :i* is ! subject ( su*
 agreem5t 9 accordance ) p>agraph       

7#b77;,c77ii74 ,a det]m9ation made by   
applicable au?ority = a jurisdiction t a
 work]s' comp5sation settlem5t agreem5t 
is 9 accordance ) ! work]s' comp5sation 
law ( ! jurisdiction %all n be subject  
to review by ! ,secret>y4  4  7c7       
,con=m+ am5dm5ts ,subsection 7b7 ( su*  
section is fur!r am5d$--  7#a7 9        
p>agraph 7#b77;,b77ii71 by /rik+ ,a     
prim>y plan & ins]t+ ,subject to        
subsections 7p7 & 7q71 a prim>y plan2   
7#b7 9 p>agraph 7#b77;,b77iii7--  7,a7 9
 ! fir/ s5t5ce1 by /rik+ ,9 ord] to     
recov] paym5t & ins]t+ ,subject to      
subsection 7q71 9 ord] to recov] paym5t2
 &  7,b7 9 ! ?ird s5t5ce1 by /rik+ ,9   
addition & ins]t+ ,subject to subsection
 7q71 9 addition2 &  7#c7 9 p>agraph    
7#c77;,a71 by /rik+ ,!re is e/abli%$ a  
private cause ( action & ins]t+ ,subject
 to subsection 7q71 !re is e/abli%$ a   
private cause ( action4  7d7 ,mod]niz+  
t]m9ology = purposes ( m$ic>e second>y  
pay] provisions ,subsection 7b77#b77;,a7
 ( su* section is am5d$ by /rik+        

workm5's comp5sation law or plan &      
ins]t+ work]s' comp5sation law or plan  
ea* place x appe>s4  #c4 ,limitation on 
liability ,! p>ties to a work]s'        
comp5sation settlem5t agreem5t :i* met !
 provisions ( section #ahfb7;b7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#aciey7b77 on ! effective date (        
settlem5t %all be accept$ z meet+ !     
requirem5ts ( su* section not)/&+ *anges
 9 law1 regulations1 or adm9i/rative    
int]pretation ( su* provisions aft] !   
effective date ( su* settlem5t4 ,no?+ 9 
section #ahfb7;b7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciey7b77 %all     
au?orize ! ,secret>y ( ,heal? & ,human  
,s]vices to impose liability t is       
additional to ! liability 9 effect on ! 
date ( ! enactm5t ( ?is ,act ) respect  
to a work]s' comp5sation settlem5t      
agreem5t ! effective date ( :i* is be=e 
su* date ( enactm5t1 except 9 ! case (  
fraud4  #d4 ,effective date ,! am5dm5ts 
made by ?is ,act %all apply to a work]s'
 comp5sation settlem5t agreem5t ) an    

effective date on or aft] ! date ( !    
enactm5t ( ?is ,act4