Navigating the Uncharted Waters of Medicare Futures
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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
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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 …
CMS’ Data Driven Approach to MSP Compliance: The Devil is in the Details
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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 …
Medical Cost Projections and Medicare Set-Asides: Two sides of the Same Coin
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October 12, 2023
Rasa Fumagalli, JD, MSCC, CMSP-F
The Differences Between an MCP & LMSA
A Medical Cost Projection (“MCP”) report helps a personal injury attorney quantify an injury victim’s future medical expenses. The report is generally prepared by a …
Would Better Billing by Providers Result in Fewer MSP Recovery Claims Cases?
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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 …
Since You Asked: Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
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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” …
11th Circuit Brings Clarity to the Statute of Limitations for Medicare Advantage Plans
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November 14, 2022
By: Kevin James, Esq.
The Medicare Secondary Payer Act (MSP) has often been described by many courts as notoriously “complex”. This complexity has only increased as Medicare Advantage Organizations (MAO) have increasingly become more litigious in attempts …
Is it Workers’ Compensation or Liability?
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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 …
#2| Since You Asked: Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
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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 …
Medicare Set-Asides for General Liability Settlements: How to Protect Your Clients and Your Practice
February 3, 2021
Rasa Fumagalli, JD, MSCC, CMSP-F and Jennifer L. Yu, Esq.
In stark contrast to the world of worker’s compensation, most attorneys agree that there is a dangerous amount of gray area surrounding the subject of Medicare …