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.
July 28, 2021 Rasa Fumagalli JD, MSCC, CMSP-F Introducing “Since You Asked,” Synergy’s first in a series of columns addressing MSP compliance questions in the area of workers’ compensation. Question: “My client is settling her case and does not know what to do with her Workers’ Compensation Medicare Set-Aside (WCMSA) funds. I’m not quite sure […]
Jason D. Lazarus, J.D., LL.M., MSCC, CSSC So, what do lawyers assisting Medicare beneficiaries do given all of the issues surrounding representing Medicare beneficiaries? To learn more, download the White Paper below: [hubspot type=form portal=7609853 id=3a31fe03-41bd-4455-a882-0b33d31ec2d0]
July 8, 2021 Rasa Fumagalli JD, MSCC, CMSP-F Most attorneys are well aware of the need to resolve Medicare’s conditional payments in connection with a client’s settlement. This obligation stems from the Medicare Secondary Payer (MSP) Act, 42 U.S.C. § 1395y(b)(2)(A)(ii), which prohibits Medicare from making payment for medical services when “payment has been made […]
Medicare is complex, to say the least. Medicare Parts A, B, C, and D all cover distinct but overlapping services. Meanwhile, Medicare eligibility is connected to Social Security Disability Income, and the Medicare Secondary Payer Act is a series of statutory provisions that would make even the most detail-oriented person’s head spin.
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 […]
May 11, 2021 Rasa Fumagalli JD, MSCC, CMSP-F The interplay between the Medicare Secondary Payer Act (MSPA) and Florida’s medical malpractice statute, Fla. Stat §§ 766.207 and 766.209 was addressed in the recent case of Gordon v. Azar, 2021 U.S. Dist.LEXIS 28314, (S. D. Fla. 2021). The issue came before the Court in the context […]
Once you’ve already identified someone as a Medicare beneficiary (or someone with the reasonable expectation of becoming one within thirty months), the easiest way to make sure you’re compliant is to follow the acronym “CAD.”
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 7 (App. Div. Jan. 5, 2021) and Abate v. Wal-Mart Stores, No. 1:17-cv-288-SPB, 2020 WL 7027481 […]
As of April 1, 2011, a Responsible Reporting Entities/insurers (RRE), (liability insurer, self-insurer, no-fault insurer, and workers’ compensation carriers) must determine whether a claimant is a Medicare beneficiary (“entitled”) and if so, provide certain information to the secretary of Health and Human Services (hereinafter “secretary”) when the claim is resolved. This is the so-called Mandatory Insurer Requirement, MIR for short.