Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide
CMS issued Version 3.6 of the Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide.
Tag: CMS
An Examination of the Role of Structured Settlements in Funding Medicare Set-Asides
There are some good reasons why many Medicare Set-Aside (MSA) arrangements today are funded with structured settlements.
Update on Proposed Liability MSA Rules and Civil Money Penalties
The Medicare Trust Fund is financially unstable. The funding for Medicare Part A, which covers hospital costs, is expected to run out by 2026.
CMS “Clarifies” Recent Revision to January 10, 2022 WCMSA Reference Guide
This controversial Section of the guide addresses CMS’ view of non-submitted Medicare Set-Aside (MSA) proposals.
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 […]
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 basic expectation in the client-lawyer relationship. Rule 1.1 states: “A lawyer shall provide competent representation […]
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 what to do with her Workers’ Compensation Medicare Set-Aside (WCMSA) funds. I’m not quite sure […]
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 employee and counsel may find themselves in receipt of a post-settlement conditional payment notice or […]
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 7 (App. Div. Jan. 5, 2021) and Abate v. Wal-Mart Stores, No. 1:17-cv-288-SPB, 2020 WL 7027481 […]