Unraveling the Conundrum of Medicare Reimbursement

January 14, 2021
Rasa Fumagalli, JD, MSCC, CMSP-F
Personal injury settlements involving Medicare beneficiaries will often have conditional payment claims by Medicare and/or Part C plan liens. Since accurate and complete information regarding Medicare’s payments may be unavailable during settlement …
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, …
Mitigating Medicare Secondary Payer Liability Related to Futures

July 9, 2020
By Jason D. Lazarus
Medicare Secondary Payer Compliance for law firms when it comes to “futures” is all about risk mitigation. How do you properly and compliantly close a file when you represent a Medicare beneficiary? The …
United States of America vs. Carrigan & Anderson, PLLC

April 29, 2020
United States of America vs. Carrigan & Anderson, PLLC, Stephen P. Carrigan: U.S. Attorney brings suit against personal injury lawyer and his firm over failing to pay back Medicare for conditional payments
By Jason D. Lazarus, J.D., …
No Time Limits on Medicare Advantage Plans Private Cause of Action for Double Damages

March 2, 2020
The 11th Circuit Court of Appeals weighed in on the question of whether the Medicare statute, which provides a three-year timeline to the government to request repayment, applies to a private entity providing Medicare benefits (Medicare …
Resolution of Conditional Payments for Personal Injury Settlements

January 17, 2020
By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC
Failure to Pay Equals Personal Liability
The government takes its reimbursement rights seriously and is willing to pursue trial lawyers who ignore Medicare’s interest. On March 18, 2019, the …
DOJ Pursues Philadelphia Law Firm Over Six Thousand Dollars’ Worth of Conditional Payments, Firm Settles with DOJ

January 8, 2020
By: Jason D. Lazarus, J.D., LL.M., MSCC
The Department of Justice (DOJ) is serious about and intent on enforcement of the Medicare Secondary Payer Act when it comes to conditional payments. There are now numerous examples of …
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 …
Medicare Compliance, or Else Redux: A Third Law Firm Settles with the DOJ for Failing to be MSP Compliant

By Jason D. Lazarus, J.D., LL.M., MSCC
The government takes its reimbursement rights seriously and is willing to pursue trial lawyers who ignore Medicare’s interest. On November 4th, 2019, The United States Attorney for the District of Maryland …
Injury Victim Gets Part B Denial of Care by Medicare

Jason D. Lazarus, J.D., LL.M., CSSC, MSCC
In the past, trial lawyers never had to worry about whether Medicare would pay for their client’s future care post-settlement. There is cause for concern that this may not be the case in …