determination disapproves such submission the 
Secretary shall include with such notification 
the specific reasons for the disapproval. A de-
termination that disapproves a submission is 
not valid if the determination does not include 
a specific explanation of each deficiency of the 
submission. 
‘‘(4) SAFE
HARBOR
FOR
CERTAIN
MEDICARE 
SET-ASIDES.— 
‘‘(A) IN GENERAL.—A Medicare set-aside 
of a workers’ compensation settlement agree-
ment shall be deemed a qualified Medicare set- 
aside if the Medicare set-aside amount is the 
safe harbor amount for the agreement. 
‘‘(B) SAFE HARBOR AMOUNT DEFINED.— 
For purposes of this paragraph, the term ‘safe 
harbor amount’ means, for a workers’ com-
pensation settlement agreement, the greater 
of— 
‘‘(i) the amount that is 10 percent of 
the present value of the agreement (as de-
termined under subsection (l)(3)); or 
‘‘(ii) the amount that is 15 percent of 
the payments provided by the agreement 
for medical expenses, including payments 
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for both items and services that are cov-
ered under this title and that are not cov-
ered under this title. 
‘‘(C) RULE
OF
CONSTRUCTION.—In the 
case of a workers’ compensation settlement 
agreement with a Medicare set-aside that is 
deemed a qualified Medicare set-aside under 
subparagraph (A), the fact that the workers’ 
compensation claimant or workers’ compensa-
tion payer involved may elect direct payment 
under paragraph (6)(A) or an adjustment 
under paragraph (2)(C)(iii) shall not be con-
strued as prohibiting such claimant or payer 
from basing the set-aside amount on the safe 
harbor amount for such agreement. 
‘‘(5) APPEALS.— 
‘‘(A) IN GENERAL.—A party to a workers’ 
compensation settlement agreement that is dis-
satisfied with a determination under paragraph 
(3)(B), upon filing a request for reconsideration 
with the Secretary not later than 60 days after 
the date of notice of such determination, shall 
be entitled to— 
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‘‘(i) reconsideration of the determina-
tion by the Secretary (with respect to such 
determination); 
‘‘(ii) a hearing before an administra-
tive judge thereon; and 
‘‘(iii) judicial review of the Secretary’s 
final determination after such hearing. 
‘‘(B) DEADLINES FOR DECISIONS.— 
‘‘(i) RECONSIDERATIONS.— 
‘‘(I) IN
GENERAL.—The Sec-
retary shall conduct and conclude a 
reconsideration of a determination 
under paragraph (3)(B) and mail the 
notice of the decision of such recon-
sideration by not later than the last 
day of the 30-day period beginning on 
the date that a request for such re-
consideration has been timely filed. 
‘‘(II) APPEALS OF RECONSIDER-
ATIONS.—If a party to the workers’ 
compensation settlement involved is 
dissatisfied with the Secretary’s deci-
sion under subclause (I), that party 
may file an appeal within the 30-day 
period after the date of receipt of the 
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