CMS’ Data Driven Approach to MSP Compliance
Injured parties should be advised about the potential impact of the MSP Act on their post-settlement injury-related care and files properly documented.
Category: Synergy InSights
Main Synergy InSights Blog Category
Would Better Billing by Providers Result in Fewer MSP Recovery Claims Cases?
MSP Recovery Claims, Series LLC, and MSPA Claims 1, LLC have filed several cases on behalf of Medicare Advantage Organizations (MAOs).
How Does Medicare Decide Which Payments Are Conditional?
Settlements involving Medicare beneficiaries require additional scrutiny to ensure compliance with the MSP Act.
Is it Workers’ Compensation or Liability?
Attorneys settling cases involving work-related injuries may find themselves similarly perplexed when it comes to whether a work-related injury will be treated as a workers’ compensation or liability case for purposes of the Medicare Secondary Payer Act (“MSP”).
Understanding Structured Settlements and Medicare Set-Asides
October 14, 2021 Samantha Webster Settlement – What to Consider for a Medicare Set-Aside (MSA) When settling a case involving a current Medicare beneficiary and before finalizing, it is important to understand what actions need to be taken to consider Medicare’s interest. What does this all mean and what are the three most important things […]
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 in federal district court. The U.S. District Court, Middle District of Florida, Tampa Division addressed in […]
Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
September 9, 2021 Samantha Webster 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 settlement annuity. Question #1: “Are there different structured settlement options to fund a Medicare Set-Aside […]
Medicare Compliance – How to be TOTALLY Medicare Compliant
Jason D. Lazarus, J.D., LL.M., MSCC, CSSC So, what do lawyers assisting Medicare beneficiaries do given all of the issues surrounding representing Medicare beneficiaries? To learn more, download the White Paper below: [hubspot type=form portal=7609853 id=3a31fe03-41bd-4455-a882-0b33d31ec2d0]
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. § 1395y(b)(2)(A)(ii), which prohibits Medicare from making payment for medical services when “payment has been made […]