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Category: MEDICARE COMPLIANCE

Take Stock of Your Firm’s MSP Compliance Protocol Before it is Too Late

Medicare MSP Compliance

March 1, 2023

Rasa Fumagalli, , JD, MSCC, CMSP-F

It is absolutely crucial that trial lawyers don’t neglect their obligation to address Medicare’s conditional payment recovery claims at settlement. While trial lawyers in a liability settlement usually address this responsibility, …

Since You Asked: Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column

Workers Compensation , MSA

February 14, 2023

Rasa Fumagalli, JD, MSCC, CMSP-F

Oftentimes an attorney representing an injured worker may simply scan the defense’s Medicare Set-Aside and assume all the future medical issues have been addressed in the MSA. This month’s “Since You Asked” …

How Does Medicare Decide Which Payments Are Conditional?

Medicare MSP Compliance

February 9, 2023

Rasa Fumagalli, JD, MSCC, CMSP-F

Settlements involving Medicare beneficiaries require additional scrutiny to ensure compliance with the MSP Act. While the Act generally prohibits Medicare from making payment when payment is expected from a primary payer (workers’ …

11th Circuit Brings Clarity to the Statute of Limitations for Medicare Advantage Plans

Medicare MSP Compliance

November 14, 2022

By: Kevin James, Esq.

The Medicare Secondary Payer Act (MSP) has often been described by many courts as notoriously “complex”.  This complexity has only increased as Medicare Advantage Organizations (MAO) have increasingly become more litigious in attempts …

Withdrawal of Long-Awaited Proposed MSP Rules for Liability Cases

Medicare MSP Compliance

October 18, 2022

By: Rasa Fumagalli, JD, MSCC, CMSP-F

Medicare has struggled over the years to provide rules clarifying existing Medicare Secondary Payer (MSP) compliance obligations when it comes to post-settlement injury-related care that is released in a liability settlement. …

Maximizing Personal Injury Recoveries While Limiting Case-Related Costs

Medicare MSP Compliance

Rasa Fumagalli, JD, MSCC, CMSP-F

Personal injury settlements rarely make an injury victim whole. In light of this, cost management decisions factor into the strategy of the case. For example, while both life care plans and medical cost projection reports …

Complying with the Medicare Secondary Payer Act When a Client has Public Benefits

Medicare MSP Compliance

August 11, 2022

Evelynn Passino, J.D.

For clients with public benefits, closing out their case is not as simple as issuing a check for their net recovery. If the client has Medicare or will be eligible soon, then steps must …

Is it Workers’ Compensation or Liability?

Medicare MSP Compliance

July 21, 2022

Rasa Fumagalli, JD, MSCC, CMSP-F

Netflix’s new baking competition show “Is it Cake” challenges judges to identify which of two identical objects is edible and which is not. Attorneys settling cases involving work-related injuries may find themselves …

Primary Payer Status Shifts from Liability Carrier to Plaintiff Post-Settlement

Medicare MSP Compliance

Rasa Fumagalli JD, MSCC, CMSP-F

In Penelope Stillwell v State Farm Fire and Casualty Co., et al. case (2021 WL 4427081), a plaintiff attempts to impose primary payer status on a liability insurer post-settlement via a qui tam action …

Beware of “Conscious Ignorance” Exception to Mutual Mistake Challenge to a Contract

September 9, 2021

Rasa Fumagalli JD, MSCC, CMSP-F

The American Bar Association’s Model Rules of Professional Conduct provide a blueprint for attorneys to follow when representing clients. The first Rule and arguably one of the most important ones, outlines a …

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