Category Archives: MSAs

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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Settlement Language Can Make or Break a Workers Compensation Case

B Josh Pettingill Appropriate settlement language can make a significant impact on the total amount of the workers’ compensation settlement, as well as dollars that the injured worker receives. This brief article will provide plaintiff/applicant attorneys with the requisite settlement language to maximize the workers’ compensation recovery, as well as protect their respective firms and…

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Reversionary Clauses and the Impact on Injured Worker

B. Josh Pettingill Reversionary clauses have become a common term of settlement in workers’ compensation cases involving a Medicare Set Aside (MSA). It is important for workers’ compensation attorneys to understand how these clauses can impact the injured worker, as well as the settlement. What is a reversionary clause? A reversionary clause means that when…

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Evidence Based MSAs (EBMAs): Don’t Accept Blindly

B Josh Pettingill Evidence Based MSAs (EBMSAs) have taken the workers’ compensation industry by storm the past several years. It is imperative for workers’ compensation attorneys to understand how EBMSAs can impact both the settlement value, as well as your clients’ benefits post-resolution. EBMSAs can be a cost savings mechanism in resolving a workers’ compensation…

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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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Taking Advantage of the WCMSA Re-Review Process

B. Josh Pettingill We frequently receive inquiries regarding workers compensation MSAs (WCMSAs) and whether it is possible to get CMS (Centers for Medicare and Medicaid Services) to re-review an MSA once an amount has already been approved. The good news is that it is possible. However, you only get one opportunity and certain criteria must…

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How to Tell if Your Client Needs a Liability MSA

In a personal injury case, Medicare set aside (MSA) arrangements can be confusing for both the plaintiff and the plaintiff’s attorney. Most personal injury attorneys don’t have the experience to coordinate MSA arrangements for their clients. A lack of experience and knowledge can lead to liability for the trial attorney involved in the case. The…

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SYNERGY MSP Compliance: Protecting Your Firm in 2019

B. Josh Pettingill CMS has established a set timeframe to roll out formal guidelines for Liability Medicare Set-Asides (LMSAs) in 2019[1]. Plaintiff attorneys must develop Medicare compliance protocols for their law firms to avoid exposing them to liability from legal malpractice pitfalls. Plaintiff attorneys must go on the offensive regarding Medicare Secondary Payer (MSP) compliance…

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7 Common Workplace Injuries That Could Require Medicare Set Aside Services

Utilizing a Medicare Set Aside for personal injury can be confusing without the help of an experienced settlement consultant from Synergy Settlement Services. Fortunately, our Medicare Set Aside (MSA) services help attorneys focus on the case at hand by allowing an experienced professional to handle the details of their client’s settlement. It’s easy to get…

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Liability MSAs: The Whole Truth and Nothing But the Truth

B. Josh Pettingill Problem 1) There is still an incredible amount of misinformation in the marketplace about Liability MSAs. Despite efforts to raise awareness and educate stakeholders about LMSAs, many of the largest liability insurance carriers are still convinced that failure to address Medicare’s future interests on liability case creates exposure for them. There is…

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Urgent Alert – Liability Medicare Set Asides: One Step Closer to Reality

CMS continues to forge ahead with establishing formal guidelines for Liability Medicare Set Asides (LMSAs). Over the past several months, The Centers for Medicare and Medicaid Services (CMS) has met with key stakeholders from the insurance industry, the plaintiff’s bar and the Medicare set aside community. These meetings were not held in a public forum…

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Big Data and Medicare – Recipe for Disaster

B. Josh Pettingill, MBA, MS, MSCC Introduction A vital step to navigating the MSP statute is understanding the dynamics between the Section 111 Reporting Requirement and the potential interplay for a Liability Medicare Set Aside (LMSA). The MSP statute precludes Medicare from paying for any item or service when payment has been made by a…

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Panter, Panter & Sampedro

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Jeffrey Meldon & Associates, P.A.

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