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 …
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, …
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 …
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 …
The Unregulated New Frontier of Medicare Set-Asides
September 29, 2020
Excerpt from The Art of Settlement
Consider this scenario: you represent a current Medicare beneficiary in a third-party liability case. As part of the workup of the case, you determine the client will need future medical care …
Medicare Expert Case Evaluations: Mitigating Medicare Secondary Payer Liability Related to Futures
July 9, 2020
By Jason D. Lazarus
Medicare Secondary Payer Compliance for law firms when it comes to “futures” is all about risk mitigation. How do you properly and compliantly close a file when you represent a Medicare beneficiary? The …
Liability Medicare Set-Asides: Proposed Regulations Now Expected in August of 2020
July 1, 2020
By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC
Late in the fall of 2018, the Office of Management and Budget issued a notification from the Department of Health and Human Services which oversees CMS of a proposed …
Medicare Advantage Plans and Workers Compensation Medicare Set-Asides
March 25, 2020
B. Josh Pettingill
We are oftentimes asked about injured workers who have a Medicare Advantage Plan (MAP) and if they still need to use their Workers’ Compensation Medicare Set-Aside (WCMSA) funds if the MAP will cover all …
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 …
No Time Limits on Medicare Advantage Plans Private Cause of Action for Double Damages
March 2, 2020
The 11th Circuit Court of Appeals weighed in on the question of whether the Medicare statute, which provides a three-year timeline to the government to request repayment, applies to a private entity providing Medicare benefits (Medicare …
