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Category: MSAs

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’ …

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 …

Understanding Structured Settlements and Medicare Set-Asides

October 14, 2021

Samantha Webster

Settlement – What to Consider for a Medicare Set-Aside (MSA)

When settling a case involving a current Medicare beneficiary and before finalizing, it is important to understand what actions need to be taken to consider …

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 …

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

Workers Compensation , MSA

September 9, 2021

Samantha Webster

Structured settlements may be used to fund a Workers’ Compensation Medicare Set-Aside (WCMSA). Samantha Webster, Synergy’s Director of Case Management, addresses two common questions that come up about funding of a WCMSA with a structured …

Medicare Compliance – How to be TOTALLY Medicare Compliant

Jason D. Lazarus, J.D., LL.M., MSCC, CSSC

So, what do lawyers assisting Medicare beneficiaries do given all of the issues surrounding representing Medicare beneficiaries?

To learn more, download the White Paper below:…

Exploring Options for Conditional Payment Resolution

July 8, 2021

Rasa Fumagalli JD, MSCC, CMSP-F

Most attorneys are well aware of the need to resolve Medicare’s conditional payments in connection with a client’s settlement. This obligation stems from the Medicare Secondary Payer (MSP) Act, 42 U.S.C. § …

The Evolution of The Workers’ Compensation Medicare Set-Aside (WCMSA) Arrangement

Workers Compensation , MSA

April 8, 2021

Rasa Fumagalli JD, MSCC, CMSP-F

The nature of the Workers’ Compensation Medicare Set-Aside (WCMSA) has evolved over the years since the 2001 Patel Memo. That evolution has seen us move from every WCMSA that met the Center …

Binding CMS to its WCMSA Determination

Workers Compensation , MSA

February 11, 2021

Rasa Fumagalli, JD, MSCC, CMSP-F

Securing CMS review of a Workers’ Compensation Medicare Set-Aside (WCMSA) proposal can, at times, be cumbersome.  Once the CMS WCMSA determination letter is received, parties may often just close their files after …

Medicare Set-Asides for General Liability Settlements: How to Protect Your Clients and Your Practice

February 3, 2021

Rasa Fumagalli, JD, MSCC, CMSP-F and Jennifer L. Yu, Esq.

In stark contrast to the world of worker’s compensation, most attorneys agree that there is a dangerous amount of gray area surrounding the subject of Medicare …

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