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 …
Since You Asked: Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
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?
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’ …
What Gives Health Care Plans The Right To Recover?
January 12, 2023
Dealing with medical liens is the dreaded case after the case for most personal injury attorneys. As a personal injury attorney, you’ve worked hard to prove the tortfeasor has liability for the damages incurred …
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. …
Complying with the Medicare Secondary Payer Act When a Client has Public Benefits
August 11, 2022
Evelynn Passino, J.D.
For clients with public benefits, closing out their case is not as simple as issuing a check for their net recovery. If the client has Medicare or will be eligible soon, then steps must …
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 …
Is the PAID Act the Solution for Locating Hidden Medicare Advantage Liens?
April 14, 2022
It is well established that Medicare has a right of reimbursement for payments it made on behalf of a Medicare beneficiary when that beneficiary obtains a settlement from a responsible party. Medicare’s right …
An Examination of the Role of Structured Settlements in Funding Medicare Set-Asides
March 14, 2022
Rasa Fumagalli JD, MSCC, CMSP-F & Samantha Webster
Many Medicare Set-Aside (MSA) arrangements today are funded with structured settlements. There are some very good reasons for doing so, which are discussed below. However, it is critical to …
Saving a Settlement
February 8, 2022
Rasa Fumagalli JD, MSCC, CMSP-F
Most workers’ compensation attorneys have probably encountered a CMS WCMSA determination that is higher than the original Workers’ Compensation Medicare Set-Aside proposal that was submitted for review. A higher WCMSA determination post …
