CMS “Clarifies” Recent Revision to January 10, 2022 WCMSA Reference Guide in Webinar
February 28, 2022
Rasa Fumagalli JD, MSCC, CMSP-F
There has been much discussion in the Medicare Secondary Payer (MSP) compliance industry over the addition of Section 4.3 to the revised Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide Version 3.5…
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 …
Negotiating Catastrophic Workers’ Comp Claims: Obtaining Maximum Value by Leveraging Settlement Experts
It is a very common practice for insurance carriers to negotiate catastrophic workers’ compensation claims using offers in the form of both upfront cash to the claimant and a structured settlement. At a minimum, any case involving a Medicare set …
From Roger Baron: SDNY holds SPD provision not enforceable under Cigna v Amara
Reprinted with permission from Roger Baron
In Durham v. Prudential Insurance, 2012 WL 3893604 (S.D.N.Y. Aug. 28, 2012), the Court was requested by the ERISA Insurer to uphold the “discretionary clause” of the SPD, but the plan document did …
