Understanding Medicare Advantage Plans: A Comprehensive Overview
June 9, 2023
Introduction:
Medicare Advantage plans have emerged as a popular option for individuals seeking comprehensive healthcare coverage beyond what traditional Medicare (Part A/B) offers. These plans, also known as Medicare Part C, provide a unique alternative to traditional …
Would Better Billing by Providers Result in Fewer MSP Recovery Claims Cases?
April 20, 2023
Rasa Fumagalli, JD, MSCC, CMSP-F
MSP Recovery Claims, Series LLC, and MSPA Claims 1, LLC have filed several cases on behalf of Medicare Advantage Organizations (MAOs) against insurers for failing to reimburse the MAOs for injury-related medical …
Take Stock of Your Firm’s MSP Compliance Protocol Before it is Too Late
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, …
11th Circuit Brings Clarity to the Statute of Limitations for Medicare Advantage Plans
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
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?
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 …
#3 | Since You Asked: Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
October 14, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
As we reflect on the 20th anniversary of the devastating September 11, 2001, terrorist attacks on US soil and all the lives lost, we cannot forget the heroic efforts of all …
Primary Payer Status Shifts from Liability Carrier to Plaintiff Post-Settlement
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 …
Beware of “Conscious Ignorance” Exception to Mutual Mistake Challenge to a Contract
September 9, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
The American Bar Association’s Model Rules of Professional Conduct provide a blueprint for attorneys to follow when representing clients. The first Rule and arguably one of the most important ones, outlines a …
#1 | Since You Asked: Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
July 28, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
Introducing “Since You Asked,” Synergy’s first in a series of columns addressing MSP compliance questions in the area of workers’ compensation.
Question:
“My client is settling her case and does not know …
