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, …
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 …
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 …
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 …
Third-Party and Workers’ Compensation Case: What about the Medicare Set-Aside?
February 13, 2020
An inquiry that Synergy receives on a regular basis involves a Medicare-eligible claimant who has both a workers’ compensation and a third-party liability companion case. The third-party liability claim has resolved and now the workers’ comp carrier …
Liability Medicare Set-Asides (LMSAs): Is It Time to Start Worrying?
B. Josh Pettingill
For over a decade, there has been episodic activity from Centers for Medicare and Medicaid Services (CMS) on Liability Medicare Set-Asides (LMSAs), including but not limited to, policy memorandums, Medicare Learning Network announcements, a notice …
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 …
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 …
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 …
