Synergy’s blog brings you the industry’s foremost thought leadership InSights on matters of healthcare lien resolution and Medicare Secondary Payer Compliance. Visit often to discover helpful InSights on important lien resolution compliance issues.
On 9/29/11, CMS issued a memorandum indicating there is no need for a liability Medicare set aside and that its interests would be satisfied if the treating physician certifies in writing that treatment for the alleged injury related to the liability insurance has been completed as of the date of settlement.
In the first memo coming from CMS HQ regarding Liability Medicare Set Asides, Charlotte Benson, Acting Director Financial Services Group for CMS, gives us an exception to the need to create a set aside. According to the memo, a liability Medicare set aside isn’t necessary when the Medicare beneficiary’s treating physician certifies in writing that all of the care related to the claimed injury has been completed as of the date of the settlement.
Some individuals are dual eligible. In plain English, this means they qualify for both Medicaid and Medicare. In certain cases, a Medicare Set Aside/Pooled Trust Sub-Account may be necessary to preserve the dual eligibility.
CMS Region 6 issued a memorandum on liability Medicare set asides (“LMSA”) which has some useful information but has limited application outside of Texas, Oklahoma, New Mexico, Louisiana and Arkansas.
On June 27th, Medicare formally resumed issuing demand letters after it halted issuance in response apparently to the Haro v. Sebelius decision. I will summarize what is new in the demand letter.
A Volusia county judge’s refusal to approve a structured settlement for a minor child was appealed in Hancock. The Fifth District Court of appeal reversed a decision by a C. McFerrin Smith which held that the court lacked legal authority to approve a structured settlement that paid out after age of majority.
The hiring of a Medicare Set Aside (“MSA”) allocation vendor is an important decision when settling a worker’s compensation or liability matter. The future medical costs included in the allocation report can make or break a case.
When a Medicare Set Aside is implemented, there are different options as far as how they are administered. The injury victim can self administer the set aside. In the alternative, a professional administrator can be hired. This may be through a custodial arrangement or a trust.
Qualified Settlement Funds are a great tool for trial lawyers to use when settling cases with complex settlement planning issues. It is a temporary holding tank that does not trigger constructive receipt.