#4 | Since You Asked: Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
June 6, 2023
Rasa Fumagalli JD, MSCC, CMSP-F
The Medicare Secondary Payer Act impacts workers’ compensation, liability, and no-fault settlements involving a Medicare beneficiary. This month’s “Since You Asked” column addresses a situation where Medicare incorrectly denies non-injury-related treatment after …
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 …
Navigating the Shifting Landscape of MSP Compliance
July 23, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
The wait for proposed rulemaking related to Medicare Secondary Payer (MSP) compliance obligations regarding future medical services in liability settlements continues. Although the Department of Health and Human Services issued their initial …
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 …
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, …
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 …
Third-Party and Workers’ Compensation Case: What about the Medicare Set-Aside?
February 13, 2020
An inquiry that Synergy receives on a regular basis involves a Medicare-eligible claimant who has both a workers’ compensation and a third-party liability companion case. The third-party liability claim has resolved and now the workers’ comp carrier …
Liability Medicare Set-Asides (LMSAs): Is It Time to Start Worrying?
B. Josh Pettingill
For over a decade, there has been episodic activity from Centers for Medicare and Medicaid Services (CMS) on Liability Medicare Set-Asides (LMSAs), including but not limited to, policy memorandums, Medicare Learning Network announcements, a notice …
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 …
