Exploring Options for Conditional Payment Resolution
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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. § …
The Evolution of The Workers’ Compensation Medicare Set-Aside (WCMSA) Arrangement
![Workers Compensation , MSA](https://partnerwithsynergy.com/wp-content/uploads/2019/05/WILG-e1562856017270.png)
April 8, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
The nature of the Workers’ Compensation Medicare Set-Aside (WCMSA) has evolved over the years since the 2001 Patel Memo. That evolution has seen us move from every WCMSA that met the Center …
Binding CMS to its WCMSA Determination
![Workers Compensation , MSA](https://partnerwithsynergy.com/wp-content/uploads/2019/05/WILG-e1562856017270.png)
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 …
Medicare Set-Asides for General Liability Settlements: How to Protect Your Clients and Your Practice
February 3, 2021
Rasa Fumagalli, JD, MSCC, CMSP-F and Jennifer L. Yu, Esq.
In stark contrast to the world of worker’s compensation, most attorneys agree that there is a dangerous amount of gray area surrounding the subject of Medicare …
Liability Medicare Set-Asides: Where are we Today?
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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, …
Medicare Expert Case Evaluations: Mitigating Medicare Secondary Payer Liability Related to Futures
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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 …
Medicare Advantage Plans and Workers Compensation Medicare Set-Asides
![Workers Compensation , MSA](https://partnerwithsynergy.com/wp-content/uploads/2019/05/WILG-e1562856017270.png)
March 25, 2020
B. Josh Pettingill
We are oftentimes asked about injured workers who have a Medicare Advantage Plan (MAP) and if they still need to use their Workers’ Compensation Medicare Set-Aside (WCMSA) funds if the MAP will cover all …
No Time Limits on Medicare Advantage Plans Private Cause of Action for Double Damages
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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 …
Third-Party and Workers’ Compensation Case: What about the Medicare Set-Aside?
![Workers Compensation , MSA](https://partnerwithsynergy.com/wp-content/uploads/2019/05/WILG-e1562856017270.png)
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?
![](https://partnerwithsynergy.com/wp-content/uploads/2019/05/Untitled-e1573577382751.png)
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 …