Liability MSAs: The Whole Truth and Nothing But the Truth
B. Josh Pettingill
Problem 1) There is still an incredible amount of misinformation in the marketplace about Liability MSAs.
Despite efforts to raise awareness and educate stakeholders about LMSAs, many of the largest liability insurance carriers are still convinced that …
Big Data and Medicare – Recipe for Disaster
B. Josh Pettingill, MBA, MS, MSCC
Introduction
A vital step to navigating the MSP statute is understanding the dynamics between the Section 111 Reporting Requirement and the potential interplay for a Liability Medicare Set Aside (LMSA). The MSP statute precludes …
Liability Medicare Set Asides (LMSAs): October is Here! Now What?
By B. Josh Pettingill, MBA, MS, MSCC & Jason D. Lazarus, J.D., LL.M., MSCC
The debate regarding addressing Medicare’s future interest in liability settlements is filled with nuance and subtleties. An essential step in understanding the big picture is starting …
Total “Medicare” Compliance in a New Age
By Jason D. Lazarus, J.D., LL.M., MSCC
“Although the statute is structurally complex—a complexity that has produced considerable confusion among courts attempting to construe it—the MSP’s function is straightforward.” US v. Baxter Intern., Inc., 345 F. 3d 866 (11th Cir. …
CMS Gearing Up to Reject Medicare Claims Related to Liability Settlements
By B. Josh Pettingill
Last week, the Centers for Medicare and Medicaid Services (CMS) released a “CMS Manual System” “One-Time Notification” regarding Liability Medicare Set Asides and enforcement of the Medicare Secondary Payer statute (MSP). Starting October 1, 2017, Medicare …
Liability MSAs: A Disconnect Between the Plaintiff’s Bar and Insurance Industry
B. Josh Pettingill, MBA, MS, MSCC
In the absence of formal guidance from Centers for Medicare and Medicaid Services (CMS), the plaintiff’s bar and the insurance industry have not agreed upon the appropriate way to protect Medicare’s interests when resolving …
A Primer on Medicare Set Aside Self-Administration
By B. Josh Pettingill, MBA, MS, MSCC
Synergy receives numerous calls every week regarding what is required to properly self-administer an MSA. The purpose of this article is to provide some guidance to attorneys regarding self-administered Medicare set aside (MSA) …
Eliminating or Getting the Lowest Medicare Set Aside on a Personal Injury Case
By B. Josh Pettingill, MBA, MS, MSCC
Plaintiff attorneys should go on the offensive in regards to any Medicare set aside (MSA) issue that may arise in a personal injury case involving a current Medicare beneficiary. According to the May …
Aranki v. Burwell – Nothing New When it comes to Liability Medicare Set-asides
By Jason D. Lazarus, J.D., LL.M, MSCC
Recently, an Arizona Federal judge ruled that he would not make a determination on whether a Medicare Set-Aside (MSA) is necessary on a medical malpractice case. According to Judge Stephen McNamee:
[t]he Court …
Medicare Advantage Plans and Liability Medicare Set Asides
By B. Josh Pettingill, MBA, MS, MSCC
Traditional Medicare vs. Medicare Advantage Plans
There is often confusion between “Traditional Medicare”, Part A and Part B coverage and Medicare Advantage Plans. It is critical to identify exactly what benefits your client …
