Synergy’s blog brings you the industry’s foremost thought leadership InSights on matters of healthcare lien resolution and Medicare Secondary Payer Compliance. Visit often to discover helpful InSights on important lien resolution compliance issues.
New Medicare Portal Goes Live January 2016 On November 9th 2015, The Centers for Medicare & Medicaid Services (CMS) announced the much anticipated, and long overdue, start date for the new Medicare Secondary Payer Recovery Portal (MSPRP). The new MSPRP will begin functioning on January 1, 2016. The current MSP Web portal permits authorized users […]
The Supreme Court issued its ruling in John Joerg, Jr., etc. et. al. v. State Farm Mutual Insurance Company on October 15, 2015. The opinion is exceedingly important as it reinforces application of the collateral sources rule to bar evidence of future Medicare benefits which may be potentially received by the plaintiff.
Clients who receive needs based benefits such as Medicaid and SSI require special planning to protect eligibility for those public benefits. More and more frequently, a pooled special needs trust is being utilized to preserve eligibility given the ease with which one can be set up and the relatively low cost.
You are the trustee of a special needs trust. Your beneficiary (Beth) lives in public housing, receives SSI (Supplemental Security Income) and MA (Medical Assistance), and has just asked you for a $200 gift card to Target so that she can buy headphones, clothes, toiletries, and some food.
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 is actually receiving before the resolution of their case. The best time to confirm public […]
Synergy Settlement Services’ experts will resolve the most difficult and complex Medicare Secondary Payer compliance challenges facing your firm. Medicare 360° is the complete solution for Medicare conditional payment resolution and Medicare Set Aside (MSA) allocations. Medicare 360° combines the most powerful services from our lien resolution group and our MSP compliance group into one […]
In Humana Medical Plan, Inc. v. Western Heritage Insurance Co., No. 12-20123, 2015 U.S. Dist. LEXIS 31875, the U.S. District Court for the Southern District of Florida granted Humana’s Motion for Summary Judgment and held that Humana’s right to reimbursement for the conditional payments it made on behalf of plan beneficiary under a Medicare Advantage […]
In Humana Medical Plan, Inc. v. Western Heritage Insurance Co., No. 12-20123, 2015 U.S. Dist. LEXIS 31875, the U.S. District Court for the Southern District of Florida granted Humana’s Motion for Summary Judgment and held that Humana’s right to reimbursement for the conditional payments it made on behalf of plan beneficiary under a Medicare Advantage […]
Repaying Medicare for conditional payments is a necessary but unpleasant process which can result in a greatly reduced net recovery or no recovery at all for an injured Medicare beneficiary. The Medicare Secondary Payer Statute has a repayment formula that is designed to maximize the return of funds to Medicare and provides no consideration for […]