Could a Law Firm Owe Double a Part C Plan Lien?
Law firms handling personal injury cases know they must protect Medicare’s interest when it comes to conditional payments. But fewer realize the steep risk involved when that Medicare claim comes from a Part C Medicare Advantage plan. Under federal law,
Understanding Medicare Conditional Payments: Timelines, Final Demands & Your Obligations
Medicare conditional payment resolution poses substantial risk for trial lawyers and paralegals when timelines slip or deadlines get missed. The Centers for Medicare and Medicaid Services (CMS) publishes formal response standards, but real-world experience may not match those expectations. Knowing
Understanding Medicare Compliance in Personal Injury Settlements
If your client is on Medicare, Medicare compliance must be part of your resolution strategy. Failing to address the Medicare Secondary Payer Act (MSP) can trigger denials of future care, government recovery actions, or worse, personal liability for your law
Medicare Advantage Plans: Resolving the Hidden Lien
In our previous blog, we tackled the Medicare conditional payment resolution process. However, if your client, during treatment for their injuries, switched to a Medicare Advantage Plan (MAO-Part C), the resolution process might not be over. Here’s why: While you
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 …
Navigating the Maze: Understanding Medicare Compliance in Personal Injury Settlements
By Jason D. Lazarus, J.D., LL.M., MSCC
Representing Medicare-eligible clients in personal injury cases introduces a layer of complexity since it requires compliance with the Medicare Secondary Payer Act (MSP). As trial lawyers, your duty extends beyond securing settlements; you …
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 …
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 …
