Category Archives: MEDICARE COMPLIANCE

Liability Medicare Set-Asides: Where are we Today?

November 12, 2020 By: Rasa Fumagalli, JD, MSCC, CMSP-F The Centers for Medicare and Medicaid Services (CMS) has been slow in providing detailed guidance in the area of liability settlements that include compensation for future medicals. To date, the guidance consists of the May 2011 CMS Stalcup memo and the September 2011 CMS memo regarding…

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What is a Medicare Set-Aside?

October 27, 2020 For many years, personal injury cases have been resolved without consideration of Medicare’s secondary payer status even though since 1980 all forms of liability insurance have been primary to Medicare. At settlement, by judgment or through an award, an injury victim would receive damages for future medical expenses that were Medicare-covered. However,…

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How the Advent of the Mandatory Insurer Requirement Causes Problems for Lawyers

October 13, 2020 As of April 1, 2011, a Responsible Reporting Entities/insurers (RRE), (liability insurer, self-insurer, no-fault insurer, and workers’ compensation carriers) must determine whether a claimant is a Medicare beneficiary (“entitled”) and if so, provide certain information to the secretary of Health and Human Services (hereinafter “secretary”) when the claim is resolved. This is…

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United States of America vs. Carrigan & Anderson, PLLC

April 29, 2020 United States of America vs. Carrigan & Anderson, PLLC, Stephen P. Carrigan:  U.S. Attorney brings suit against personal injury lawyer and his firm over failing to pay back Medicare for conditional payments By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC In yet another example of Medicare compliance-related issues, a Houston law firm…

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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

January 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…

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