Achieving Total Medicare Compliance: Essential Steps for Personal Injury Lawyers
Navigating Medicare compliance is a critical task when handling personal injury settlements involving Medicare beneficiaries. Ensuring total compliance with the Medicare Secondary Payer Act (MSP) requires a strategic approach and thorough understanding of the law/regulations. This blog post is a …
Navigating the Uncharted Waters of Medicare Futures
By Jason D. Lazarus, J.D., LL.M., MSCC
Medicare’s clear as mud position on post-settlement care coverage in liability settlements poses significant challenges for personal injury attorneys. Understanding and addressing the potential denial of future injury-related care is crucial to safeguarding …
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 …
Do Hospitals and Providers Have to Bill Insurance, Including Medicare and Medicaid?
Introduction
The landscape of healthcare billing can be complex and confusing, both for healthcare providers and patients alike. When there is third-party liability involved, such as in cases of accidents or injuries caused by someone other than …
Top Cases for Lien Resolution
Teresa Kenyon, Esq. and Kevin James
Effectively minimizing or eliminating the reimbursement of any claimed medical lien is a critical part of ensuring just compensation for the injured. Personal injury lawyers encounter numerous obstacles in the process of resolving liens. …
Understanding Medicare Advantage Plans: A Comprehensive Overview
June 9, 2023
Introduction:
Medicare Advantage plans have emerged as a popular option for individuals seeking comprehensive healthcare coverage beyond what traditional Medicare (Part A/B) offers. These plans, also known as Medicare Part C, provide a unique alternative to traditional …
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 …
Would Better Billing by Providers Result in Fewer MSP Recovery Claims Cases?
April 20, 2023
Rasa Fumagalli, JD, MSCC, CMSP-F
MSP Recovery Claims, Series LLC, and MSPA Claims 1, LLC have filed several cases on behalf of Medicare Advantage Organizations (MAOs) against insurers for failing to reimburse the MAOs for injury-related medical …
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” …
