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Tag: Medicare Compliance

Take Stock of Your Firm’s MSP Compliance Protocol Before it is Too Late

Medicare MSP Compliance

March 1, 2023

Rasa Fumagalli, , JD, MSCC, CMSP-F

It is absolutely crucial that trial lawyers don’t neglect their obligation to address Medicare’s conditional payment recovery claims at settlement. While trial lawyers in a liability settlement usually address this responsibility, …

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

Workers Compensation , MSA

February 14, 2023

Rasa Fumagalli, JD, MSCC, CMSP-F

Oftentimes an attorney representing an injured worker may simply scan the defense’s Medicare Set-Aside and assume all the future medical issues have been addressed in the MSA. This month’s “Since You Asked” …

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’ …

11th Circuit Brings Clarity to the Statute of Limitations for Medicare Advantage Plans

Medicare MSP Compliance

November 14, 2022

By: Kevin James, Esq.

The Medicare Secondary Payer Act (MSP) has often been described by many courts as notoriously “complex”.  This complexity has only increased as Medicare Advantage Organizations (MAO) have increasingly become more litigious in attempts …

Withdrawal of Long-Awaited Proposed MSP Rules for Liability Cases

Medicare MSP Compliance

October 18, 2022

By: Rasa Fumagalli, JD, MSCC, CMSP-F

Medicare has struggled over the years to provide rules clarifying existing Medicare Secondary Payer (MSP) compliance obligations when it comes to post-settlement injury-related care that is released in a liability settlement. …

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 …

Post-Settlement Conditional Payment Issues in Workers’ Compensation Claims

Workers Compensation , MSA

May 13, 2021

Rasa Fumagalli JD, MSCC, CMSP-F

The conditional payment recovery process in a workers’ compensation claim is not always smooth. Although the workers’ compensation insurance carrier will generally resolve any conditional payments in an accepted claim, the injured …

Beware of Problematic Medicare Secondary Payer Compliance Settlement Terms

April 15, 2021

Rasa Fumagalli JD, MSCC, CMSP-F

Medicare Secondary Payer (MSP) compliance settlement terms utilized by defendants are often overly broad in nature. The recent opinion, Kupolati v. Village of Timber Creek Association, 2021 N.J. Super. Unpub. LEXIS …

CMS Continues Push to Reduce Improper Payments Under the Medicare Program

December 10, 2020

Rasa Fumagalli, JD, MSCC, CMSP-F

The Centers for Medicare & Medicaid Services (CMS) recently issued a press release announcing a steady decline in improper payments under the Medicare Fee-For-Service program over the past few years. The improper …

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 …

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