Medical Cost Projections and Medicare Set-Asides: Two sides of the Same Coin

October 12, 2023
Rasa Fumagalli, JD, MSCC, CMSP-F
The Differences Between an MCP & LMSA
A Medical Cost Projection (“MCP”) report helps a personal injury attorney quantify an injury victim’s future medical expenses. The report is generally prepared by a …
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” …
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 …
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 …
#2| Since You Asked: Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column

September 9, 2021
Structured settlements may be used to fund a Workers’ Compensation Medicare Set-Aside (WCMSA). Samantha Webster, Synergy’s Director of Case Management, addresses two common questions that come up about funding of a WCMSA with a structured …
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, …
The Unregulated New Frontier of Medicare Set-Asides

September 29, 2020
Excerpt from The Art of Settlement
Consider this scenario: you represent a current Medicare beneficiary in a third-party liability case. As part of the workup of the case, you determine the client will need future medical care …
Liability Medicare Set-Asides (LMSAs): Insurance Policy for All

March 12, 2020
B. Josh Pettingill
This article highlights why a Medicare Set-Aside (MSA) should be viewed by all settlement parties as an insurance policy – nothing more, nothing less. Medicare Secondary Payer Compliance is not a scare tactic, nor …