Goodbye Chevron deference: What does this mean for Medicare Secondary Payer compliance?
By: Rasa Fumagalli, JD, MSCC, CMSP-F
The United States Supreme Court overruled the Chevron doctrine in the recent case of Loper Bright Enterprises et al v Raimondo , Secretary of Commerce , et al. ( No. 22-451, 604 U.S. ____(2024)22-451). …
CMS’ Data Driven Approach to MSP Compliance
Rasa Fumagalli, JD, MSCC, CMSP-F
It is well established that parties to a settlement involving a current Medicare beneficiary should consider Medicare’s potential interest in the settlement. This interest comes from the Medicare Secondary Payer (“MSP”) Act and supporting regulations which …
Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
June 6, 2023
Rasa Fumagalli JD, MSCC, CMSP-F
The Medicare Secondary Payer Act impacts workers’ compensation, liability, and no-fault settlements involving a Medicare beneficiary. This month’s “Since You Asked” column addresses a situation where Medicare incorrectly denies non-injury-related treatment after …
Synergy’s Workers’ Compensation Medicare Secondary Payer Advice
February 14, 2023
Rasa Fumagalli, JD, MSCC, CMSP-F
Oftentimes an attorney representing an injured worker may simply scan the defense’s Medicare Set-Aside and assume all the future medical issues have been addressed in the MSA. This month’s “Since You Asked” …
How Does Medicare Decide Which Payments Are Conditional?
February 9, 2023
Rasa Fumagalli, JD, MSCC, CMSP-F
Settlements involving Medicare beneficiaries require additional scrutiny to ensure compliance with the MSP Act. While the Act generally prohibits Medicare from making payment when payment is expected from a primary payer (workers’ …
Complying with the Medicare Secondary Payer Act When a Client has Public Benefits
August 11, 2022
Evelynn Passino, J.D.
For clients with public benefits, closing out their case is not as simple as issuing a check for their net recovery. If the client has Medicare or will be eligible soon, then steps must …
Is it Workers’ Compensation or Liability?
July 21, 2022
Rasa Fumagalli, JD, MSCC, CMSP-F
Netflix’s new baking competition show “Is it Cake” challenges judges to identify which of two identical objects is edible and which is not. Attorneys settling cases involving work-related injuries may find themselves …
Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide
March 24, 2022
Rasa Fumagalli JD, MSCC, CMSP-F
The Centers for Medicare and Medicaid Services (CMS) issued Version 3.6 of the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide (“Guide”) on March 15, 2022. It softened the language …
An Examination of the Role of Structured Settlements in Funding Medicare Set-Asides
March 14, 2022
Rasa Fumagalli JD, MSCC, CMSP-F & Samantha Webster
Many Medicare Set-Aside (MSA) arrangements today are funded with structured settlements. There are some very good reasons for doing so, which are discussed below. However, it is critical to …
Update on Proposed Liability MSA Rules and Civil Money Penalties
March 3, 2022
Rasa Fumagalli JD, MSCC, CMSP-F
The Medicare Trust Fund is financially unstable. At this time, the funding for Medicare Part A, which covers hospital costs, is expected to run out by 2026. In light of this bleak …
