Deciphering MSP Compliance Settlement Terms
Settlement documents, such as the release, for cases involving Medicare beneficiaries will often contain puzzling boilerplate Medicare Secondary Payer (MSP) compliance terms. At times, you may also see lengthy addendums to the release that appear to have been copied straight …
When Is Medicare At Fault
Guest blog
When you visit a doctor, you expect a certain level of care. This comes from both the doctor and your health care coverage provider such as Medicare. Unfortunately, patients do not always receive the care they deserve, but …
Medicare Compliance: Reducing MSP Liability for your PI Firm
By Jason D. Lazarus, J.D., LL.M., MSCC
When representing a Medicare beneficiary, personal injury law firms should prioritize compliance with the Medicare Secondary Payer Act (MSP). Inadequate compliance processes can lead to severe consequences, including government actions against the firm. …
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 …
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 …
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 …
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, …
Workers’ Compensation Case: What about the Medicare Set-Aside?
February 13, 2020
An inquiry that Synergy receives on a regular basis involves a Medicare-eligible claimant who has both a workers’ compensation and a third-party liability companion case. The third-party liability claim has resolved and now the workers’ comp carrier …
Liability Medicare Set-Asides (LMSAs): Is It Time to Start Worrying?
B. Josh Pettingill
For over a decade, there has been episodic activity from Centers for Medicare and Medicaid Services (CMS) on Liability Medicare Set-Asides (LMSAs), including but not limited to, policy memorandums, Medicare Learning Network announcements, a notice …
Liability Medicare Set-Aside (MSA) Case Studies: Eliminate, Reduce & Comply
B. Josh Pettingill
There is mounting evidence that the Centers for Medicare and Medicaid Services (CMS) will establish formal guidelines for liability MSAs in the imminent future. Medicare Secondary Payor compliance related to future medical care is an issue that …
