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 …
Workers’ Compensation Medicare Set-Aside (WCMSA) Arrangement
April 8, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
The nature of the Workers’ Compensation Medicare Set-Aside (WCMSA) has evolved over the years since the 2001 Patel Memo. That evolution has seen us move from every WCMSA that met the Center …
Electronic Payment Feature of Medicare Secondary Payer Recovery Portal
February 23, 2021
Rasa Fumagalli, JD, MSCC, CMSP-F
The Centers for Medicare & Medicaid Services (CMS) agency has made significant improvements over the years in their online self-service tools for Medicare beneficiaries, their representatives, insurers, and recovery agents. Beneficiaries may …
Unraveling the Conundrum of Medicare Reimbursement
January 14, 2021
Rasa Fumagalli, JD, MSCC, CMSP-F
Personal injury settlements involving Medicare beneficiaries will often have conditional payment claims by Medicare and/or Part C plan liens. Since accurate and complete information regarding Medicare’s payments may be unavailable during settlement …
Liability Medicare Set-Asides: Where are we Today?
November 12, 2020
By: Rasa Fumagalli, JD, MSCC, CMSP-F
The Centers for Medicare and Medicaid Services (CMS) has been slow in providing detailed guidance in the area of liability settlements that include compensation for future medicals. To date, …
United States of America vs. Carrigan & Anderson, PLLC
April 29, 2020
United States of America vs. Carrigan & Anderson, PLLC, Stephen P. Carrigan: U.S. Attorney brings suit against personal injury lawyer and his firm over failing to pay back Medicare for conditional payments
By Jason D. Lazarus, J.D., …
No Time Limits on Medicare Advantage Plans Private Cause of Action for Double Damages
March 2, 2020
The 11th Circuit Court of Appeals weighed in on the question of whether the Medicare statute, which provides a three-year timeline to the government to request repayment, applies to a private entity providing Medicare benefits (Medicare …
DOJ Pursues Philadelphia Law Firm Over Six Thousand Dollars’ Worth of Conditional Payments, Firm Settles with DOJ
January 8, 2020
By: Jason D. Lazarus, J.D., LL.M., MSCC
The Department of Justice (DOJ) is serious about and intent on enforcement of the Medicare Secondary Payer Act when it comes to conditional payments. There are now numerous examples of …
