The Official Medicare Set Aside Blog And Information Resource

$40 Million Dollars Paid by Insurance Carriers and 13,000 California Patients Affected in an Alarming Kickback Scheme

Fraud, Medicare Set-Aside Blog, Work Comp on April 21, 2017 | Posted by Jean S. Goldstein, JD

Yesterday, 26 defendants (21 doctors, 2 pharmacists, 1 physician assistant, and 2 business owners) were criminally charged in connection with a 40-million-dollar kickback scheme affecting 13,000 California patients statewide.  Two defendants, Tanya King and Christopher King “the Kings”, allegedly masterminded a complex insurance fraud scheme by recruiting both pharmacists and doctors to prescribe medically unnecessary […] Continue

Arkansas Act 1058: What About a Carrier’s Obligations Under the Medicare Secondary Payer Act?

Medicare Set-Aside Blog, MSP News, State Regulations on April 19, 2017 | Posted by Jean S. Goldstein, JD

Senate Bill 760, or Act 1058 (“the Act”) was signed into law on April 7, 2017.  The initial purpose of the Act was to clarify the Workers’ Compensation Death and Permanent Total Disability Trust Fund.  However, the bill was revised to expand the Arkansas Workers’ Compensation Commission’s ability to consider and finalize specific settlements.  Act […] Continue

Comp Laude Award Nominations Are Now Open

Medicare Set-Aside Blog on April 4, 2017 | Posted by Jean S. Goldstein, JD

WorkCompCentral is accepting nominations for its 2017 Comp Laude™ Awards.  The awards recognize integrity, excellence, and success in the workers’ compensation industry.  Each year, nominations are received and reviewed by a panel of industry judges, and awards are presented by WorkCompCentral at the annual Comp Laude® Gala. We encourage you to take a moment to […] Continue

Guaranteeing the Uncertain: Reversions and the ROI on a Structured Annuity

CMS, Medicare Set-Aside Blog, Structured Settlements on April 3, 2017 | Posted by Laura Johnson

The concept of reversions is a topic that surfaces frequently in our structured settlement department.  These clauses can seem confusing, sometimes made more complicated by uncertain futures; however, they are actually straightforward with tangible benefits associated with them.  There are two primary questions we hear the most when clients are asking how they can recover […] Continue

FDA Advisory Committee Finds Opana ER Risks Outweigh Benefits

FDA, Medicare Set-Aside Blog, Rx/Pharmacy on March 21, 2017 | Posted by Erin O'Neill, PA-C, JD

On March 14, 2017, a Food and Drug Administration (FDA) advisory committee found that the risks associated with use of Opana ER (oxymorphone hydrochloride) outweighed the potential benefits. Opana ER is an opioid pain medication, which was first introduced in 2006 and then reintroduced in a new abuse deterrent formulation in 2012. The new formulation was designed […] Continue

Jennifer Jordan, Featured Speaker at the 2017 ALFA International Seminar

Medicare Set-Aside Blog, MEDVAL News, News and Events on March 20, 2017 | Posted by Jean S. Goldstein, JD

This week, Jennifer Jordan, our Chief Legal Officer, will be a featured speaker at the 2017 ALFA International – Workers’ Compensation Practice Group Seminar in Austin, Texas.  Jennifer will be co-presenting with Beth Hostetler of Albertsons-Safeway and will discuss ways to solve Medicare Secondary Payer (MSP) challenges, including ensuring compliance with the Medicare Secondary Payer […] Continue

MAO Recovery & Courts: Aggressively Pursuing Liens

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP Litigation, MSP News on March 17, 2017 | Posted by Jean S. Goldstein, JD

On Wednesday, in the second decision of its kind this month, the United States District Court, Southern District of Florida denied in part and granted in part a Motion to Dismiss in a Medicare Advantage Organization (MAO) Medicare Secondary Payer Act (MSPA) recovery claim. MSPA Claims 1, LLC, et al. v. Century Surety Company, No. […] Continue

SPARC Act/Part D Prescription Drug Reform Reintroduced. What Does It Mean for MSP Recovery?

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News on February 24, 2017 | Posted by Jean S. Goldstein, JD

In September 2016, House Representative Bill 6120 known as the Secondary Payer Advancement, Reconciliation, and Clarification (SPARC) Act was first introduced to Congress.  The bill did not pass at that time, but was just recently reintroduced into the House of Representatives as HR 1122.  Text of the recent bill is not yet available. The bill […] Continue

WCRC RFP Due Date Revised, Again.

CMS, Medicare Set-Aside Blog, Medicare Set-Asides on February 10, 2017 | Posted by Jean S. Goldstein, JD

CMS just issued an additional amendment to the RFP for the WCMSA review contractor. The amendment published additional responses to questions by offerors, and also a change in the due date for proposals to 10:00 am February 15, 2017. The amendment to the solicitation can be found here. Stay tuned for more details. Continue