CMS Gearing Up to Reject Medicare Claims Related to Liability Settlements: LMSAs on the Horizon
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 …
Recent Liability Medicare Set Aside Case Law – No MSA Needed
B. Josh Pettingill, MBA, MS, MSCC
Vice President of MSP Compliance
The “law” as it relates to Medicare Set Asides in liability settlements is an evolving area with new developments happening quite frequently. This year there have already been several …
Liability Medicare Set Asides, Insurance Carriers and Unsubstantiated Demands
Insurance carriers are bringing up the Medicare set aside (MSA) “issue” when it comes time to draft the release more frequently. In many instances, the plaintiffs are not yet eligible for Medicare benefits, nor may they ever be entitled to …
CMS Withdraws MSP Future Medicals Rule: No Regulations – is it Good News?
The Centers for Medicare & Medicaid Services (CMS) has officially withdrawn their Notice of Proposed Rulemaking (NPRM) for protecting Medicare’s future interests with respect to future medicals. The NPRM was originally submitted to the Office of Management and Budget (OMB) …
FL Supreme Court Overturns Med Mal Caps
In a well reasoned opinion, the Florida Supreme Court has overtuned the unfair medical malpractice caps. These caps devalued human life as children and seniors who were not breadwinners, could be the victim of malpractice with no real ability for …
