Category Archives: MEDICARE COMPLIANCE

Liability Medicare Set-Asides (LMSAs): Insurance Policy for All

March 12, 2020 B. Josh Pettingill This article highlights why a Medicare Set-Aside (MSA) should be viewed by all settlement parties as an insurance policy – nothing more, nothing less. Medicare Secondary Payer Compliance is not a scare tactic, nor is it something to be disregarded. Rather, addressing the MSP by analyzing the need for…

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Resolution of Conditional Payments for Personal Injury Settlements

1/17/2020 By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC Failure to Pay Equals Personal Liability The government takes its reimbursement rights seriously and is willing to pursue trial lawyers who ignore Medicare’s interest.  On March 18, 2019, the United States Attorney for the District of Maryland announced that a Maryland personal injury law firm had…

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Liability Medicare Set-Asides (LMSAs): Is It Time to Start Worrying?

B. Josh Pettingill For over a decade, there has been episodic activity from Centers for Medicare and Medicaid Services (CMS) on Liability Medicare Set-Asides (LMSAs), including but not limited to, policy memorandums, Medicare Learning Network announcements, a notice of proposed rulemaking with subsequent withdrawal, an advanced notice of a notice of proposed rulemaking as well…

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The Interplay between Medicare and Medicaid for Injured Workers

Jason D. Lazarus, Esq. This blog post will discuss dual eligibility for injured workers.  It will address exactly what it is and how Medicaid coordinates with Medicare for those that are dual-eligible.  Finally, it will talk about the techniques to preserve Medicaid and Medicare. Some individuals are “dual eligible” meaning they qualify for both Medicaid…

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Injury Victim Gets Part B Denial of Care by Medicare

Jason D. Lazarus, J.D., LL.M., CSSC, MSCC In the past, trial lawyers never had to worry about whether Medicare would pay for their client’s future care post-settlement. There is cause for concern that this may not be the case in the future.  Consider this scenario – you represent a current Medicare beneficiary in a third-party…

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Liability Medicare Set-Aside (MSA) Case Studies: Eliminate, Reduce & Comply

B. Josh Pettingill There is mounting evidence that the Centers for Medicare and Medicaid Services (CMS) will establish formal guidelines for liability MSAs in the imminent future.  Medicare Secondary Payor compliance related to future medical care is an issue that can’t be ignored but that doesn’t necessarily mean setting up a Medicare Set-Aside on every…

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How to Close Cases Ethically & Compliantly for Disabled Clients

Jason D. Lazarus Suffering even a moderate personal physical injury can create difficult challenges both financially and emotionally for even the strongest among us.  However, what happens when someone suffers a serious or catastrophic personal physical injury causing permanent disability?  Do they get the proper counseling regarding the form of the settlement to protect their…

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Medicare Advantage Private Cause of Action is Now Sweeping the Country

Medicare Advantage Private Cause of Action is Now Sweeping the Country Courts across the country continue to rule that Medicare Advantage Plans (MAP or MAO) are enforceable and shall be entitled to double damages if not repaid in third party liability situations.  The trial bar has been aware of this significant exposure since 2016 when…

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New Medicare Portal Goes Live January 2016

New Medicare Portal Goes Live January 2016 On November 9th 2015, The Centers for Medicare & Medicaid Services (CMS) announced the much anticipated, and long overdue, start date for the new Medicare Secondary Payer Recovery Portal (MSPRP).  The new MSPRP will begin functioning on January 1, 2016.  The current MSP Web portal permits authorized users…

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TESTIMONIALS

“Synergy is our guiding light for deferring our contingent legal fees and planning for retirement. The lawyers at Panter Panter & Sampedro, myself included, have been working with them for over ten years using different methods to defer comp and plan for retirement.”

Brett Panter
Panter, Panter & Sampedro

"I don't think I've directly said "thank you" for helping us with Bridgett’s case. We sent the reduced payment to Medicaid and called Bridgett's mom to tell her approximately how much money was going to be left for Bridgett and she broke down over the telephone. Given only $25k of insurance and a $850k medical bill from the hospital she didn't think Bridgett would ever see a penny."

Tom L. Copeland
Jeffrey Meldon & Associates, P.A.

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