Tag Archives: Workers Compensation

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

September 9, 2021 Samantha Webster 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 settlement annuity. Question #1: “Are there different structured settlement options to fund a Medicare Set-Aside…

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Post-Settlement Conditional Payment Issues in Workers’ Compensation Claims

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 employee and counsel may find themselves in receipt of a post-settlement conditional payment notice or…

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Medicare Secondary Payer Compliance Challenges in WC Cases

March 11, 2021 Rasa Fumagalli JD, MSCC, CMSP-F Medicare Secondary Payer compliance issues in workers’ compensation cases are generally straightforward when the parties seek review of the Workers’ Compensation Medicare Set-Aside (WCMSA) proposal and proposed settlement by the Centers for Medicare and Medicaid Services (CMS). Oftentimes the employer/carrier will elect to fund the CMS-approved WCMSA…

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Binding CMS to its WCMSA Determination

February 11, 2021 Rasa Fumagalli, JD, MSCC, CMSP-F Securing CMS review of a Workers’ Compensation Medicare Set-Aside (WCMSA) proposal can, at times, be cumbersome.  Once the CMS WCMSA determination letter is received, parties may often just close their files after the settlement funds are disbursed. This brief article will address the frequently overlooked CMS determination…

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WCMSAs and Non-Submit Programs

B. Josh Pettingill Many carriers are moving to “non-submit programs” using Evidence-Based MSAs as the driving force for the change[i]. Getting approval of a Medicare Set-Aside is never required by any law or statute. There are times when not submitting the Workers’ Compensation Medicare Set-Aside (WCMSA) makes sense in order to achieve a resolution. Most…

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Settlement Language Can Make or Break a Workers Compensation Case

B Josh Pettingill Appropriate settlement language can make a significant impact on the total amount of the workers’ compensation settlement, as well as dollars that the injured worker receives. This brief article will provide plaintiff/applicant attorneys with the requisite settlement language to maximize the workers’ compensation recovery, as well as protect their respective firms and…

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Evidence Based MSAs (EBMAs): Don’t Accept Blindly

B Josh Pettingill Evidence Based MSAs (EBMSAs) have taken the workers’ compensation industry by storm the past several years. It is imperative for workers’ compensation attorneys to understand how EBMSAs can impact both the settlement value, as well as your clients’ benefits post-resolution. EBMSAs can be a cost savings mechanism in resolving a workers’ compensation…

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Taking Advantage of the WCMSA Re-Review Process

B. Josh Pettingill We frequently receive inquiries regarding workers compensation MSAs (WCMSAs) and whether it is possible to get CMS (Centers for Medicare and Medicaid Services) to re-review an MSA once an amount has already been approved. The good news is that it is possible. However, you only get one opportunity and certain criteria must…

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Jeffrey Meldon & Associates, P.A.

Understanding Structured Settlements and Medicare Set-AsidesThird Thursday Webinar Series

The parties agree that a Medicare Set-Aside is needed, now what? In this month's webinar, presented by Synergy CEO, Jason D. Lazarus, you will learn about the process basics for setting up a set aside including MSA allocations, funding mechanisms for set-asides, post-settlement administration as well as an overview of the process to make sure you close the case compliantly.

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