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.
Consider this scenario: you represent a current Medicare beneficiary in a third-party liability case. As part of the workup of the case, you determine the client will need future medical care related to the injuries suffered, and you settle the case. Since the client is a Medicare beneficiary, the defendant will report the settlement under the Mandatory Insurer Reporting law as it is greater than $750 in gross settlement proceeds.