Primary Payer Status Shifts from Liability Carrier to Plaintiff Post-Settlement
Rasa Fumagalli JD, MSCC, CMSP-F
In Penelope Stillwell v State Farm Fire and Casualty Co., et al. case (2021 WL 4427081), a plaintiff attempts to impose primary payer status on a liability insurer post-settlement via a qui tam action …
Beware of “Conscious Ignorance” Exception to Mutual Mistake Challenge to a Contract
September 9, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
The American Bar Association’s Model Rules of Professional Conduct provide a blueprint for attorneys to follow when representing clients. The first Rule and arguably one of the most important ones, outlines a …
Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
September 9, 2021
Structured settlements may be used to fund a Workers’ Compensation Medicare Set-Aside (WCMSA). Samantha Webster, Synergy’s Director of Case Management, addresses two common questions that come up about funding of a WCMSA with a structured …
What Should You Do About Possible Health Insurance Liens?
August 12, 2021
When handling a third-party liability case and you know your client had health insurance that paid the medical expenses, should you check to see if there is a lien interest on the settlement funds? …
Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
July 28, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
Introducing “Since You Asked,” Synergy’s first in a series of columns addressing MSP compliance questions in the area of workers’ compensation.
Question:
“My client is settling her case and does not know …
Navigating the Shifting Landscape of MSP Compliance
July 23, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
The wait for proposed rulemaking related to Medicare Secondary Payer (MSP) compliance obligations regarding future medical services in liability settlements continues. Although the Department of Health and Human Services issued their initial …
Exploring Options for Conditional Payment Resolution
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. § …
Post-Settlement Conditional Payment Issues in Workers’ Compensation Claims
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 …
Convoluted Conditional Payment Arguments Fail to Persuade Court in Florida Collateral Source Case
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 …
Beware of Problematic Medicare Secondary Payer Compliance Settlement Terms
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 …
