Understanding Medicare Advantage Plans: A Comprehensive Overview
June 9, 2023
Introduction:
Medicare Advantage plans have emerged as a popular option for individuals seeking comprehensive healthcare coverage beyond what traditional Medicare (Part A/B) offers. These plans, also known as Medicare Part C, provide a unique alternative to traditional …
Would Better Billing by Providers Result in Fewer MSP Recovery Claims Cases?
April 20, 2023
Rasa Fumagalli, JD, MSCC, CMSP-F
MSP Recovery Claims, Series LLC, and MSPA Claims 1, LLC have filed several cases on behalf of Medicare Advantage Organizations (MAOs) against insurers for failing to reimburse the MAOs for injury-related medical …
Take Stock of Your Firm’s MSP Compliance Protocol Before it is Too Late
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
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?
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
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
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
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
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?
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 …
