The Official Medicare Set Aside Blog And Information Resource

Another MSP Case Invades a Jurisdiction: The Sixth… This Time.

Medicare Advantage, Medicare Set-Asides, MSP Litigation on July 19, 2018
Posted by Jean S. Goldstein, JD

Another Medicare Secondary Payer (MSP) case involving the well-known entities, MAO-MSO, Recovery II, LLC MSP Recovery, LLC and MSPA Claims 1, LLC (“Plaintiffs”) has arisen out of the Sixth Circuit.[1] (MAO-MSO Recovery II, LLC v. Progressive Corp., No. 1:17CV390, 2018 U.S. Dist. LEXIS 119046, (N.D. Ohio July 17, 2018).  This recent opinion is issued in […] Continue

Rumor Has It……a Formal Review Program for Liability/No Fault MSAs Is on Hold….

Liability, Medicare, Medicare Set-Aside Blog, MSP News on July 12, 2018
Posted by Jean S. Goldstein, JD

You may have seen the recent chatter among the Medicare Secondary Payer community that implementation of a formal voluntary Liability MSA (LMSA) and No-Fault MSA (NFMSA) review program is on hold. Some in the industry have even discussed that the program is on hold for another eighteen months. Recall that in 2016, we first blogged […] Continue

CMS Releases Updated Medicare Secondary Payer Recovery Portal User Guide Noting Enhancements to the Portal

CMS, Conditional Payments, MSP News on July 10, 2018
Posted by Jean S. Goldstein, JD

CMS recently released an updated Medicare Secondary Payer Recovery Portal (MSRP) user guide in the hopes to lead to some more efficient practices.  A summary of the updates is as follows:   To reduce the number of calls received by the BCRC regarding the status of case correspondence, a new read-only Letter Activity tab has […] Continue

Structured Settlements 101: Making the Most of Your Settlements

Medicare Set-Aside Blog, Structured Settlements on July 3, 2018
Posted by Katharine Rupp, JD

Structured settlements are regularly overlooked as a viable and valuable option for funding a settlement. They are commonly perceived as extremely complicated and the potential benefits are often overshadowed by the temptation of a large lump sum payout. However, in practice, structured settlements are incredibly simple. What is a Structured Settlement? Structured settlements are settlements […] Continue

Professional Administration: The Last Piece of the MSP Compliance Puzzle

CMS, Medicare Set-Asides, Professional Administration on June 26, 2018
Posted by Jean S. Goldstein, JD

It has been nearly one year since the Centers for Medicare & Medicaid Services (CMS) first released a revised Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide,[1] which addressed one of the lesser discussed topics in Medicare Secondary Payer (MSP) compliance: professional administration.  Specifically, the revised guide included the following statement: “[a]lthough beneficiaries may act as […] Continue

Senate Bill 3079, Legislation to Band-Aid the Medicare Set-Aside Process Has Been Introduced

Legislation, Medicare Set-Asides, MSP News on June 21, 2018
Posted by Jean S. Goldstein, JD

You may recall in 2014, Senators Portman and Nelson introduced a Senate Bill, “[t]o amend title XVIII of the Social Security Act to provide for the application of Medicare secondary payer rules to certain workers’ compensation settlement agreements and qualified Medicare set-aside provisions.”  However, the legislation failed and never made it out of the Committee on […] Continue

U.S. Attorney’s Office Settles Conditional Payments Debts with Personal Injury Law Firm and Requires Attorney to Institute Best Internal Compliance Practices

Conditional Payments, Medicare, MSP News on June 20, 2018
Posted by Jean S. Goldstein, JD

On Monday, the U.S. Department of Justice’s Attorney’s Office for the Eastern District of Pennsylvania issued a press release concerning a settlement arrangement involving the repayment of conditional payments.  U.S. Attorney William M. McSwain announced that the Philadelphia personal injury law firm, Rosenbaum & Associates, and its principal, Jeffrey Rosenbaum entered into a settlement agreement […] Continue

Another MSP Case; Another Court’s Interpretation: Court finds Personal Representative Has Standing to Bring Private Cause of Action  

Medicare Set-Aside Blog, MSP Litigation, MSP News on June 12, 2018
Posted by Jean S. Goldstein, JD

Last week, the Fourth Circuit was added to the list of recent jurisdictions addressing the private cause of action provision under the Medicare Secondary Payer act.  The Fourth Circuit has jurisdiction over the District Courts in the states of Maryland, North Carolina, South Carolina, Virginia and West Virginia. In Netro v. Greater Balt. Med. Ctr. […] Continue

2018 Social Security and Medicare Trustees’ Report Issued; Warn of Depletion of Trust Funds

Medicare, Medicare Set-Aside Blog, MSP News, Social Security on June 7, 2018
Posted by Jean S. Goldstein, JD

Each year, the board of trustees of the Social Security Trust Fund and Medicare Trust Fund release reports to Congress providing an estimated projected financial outlook for the programs. This week both reports were released.  The 77th annual Social Security Report can be found here, and the 53rd annual Medicare report can be found here.  […] Continue

MAP Action Dismissed; Illinois Does Not Join Jurisdictions Allowing for Double Damages, Private Cause of Action…For Now

Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation, MSP News on June 5, 2018
Posted by Jean S. Goldstein, JD

Over the last several years, we have blogged about MSP Recovery, LLC, a law firm, that has been championing claims nationwide on behalf of Medicare Advantage Plans (MAP).  In their pursuits, MSP Recovery, has alleged that Non-Group Health Plans (NGHPs) are failing to make payment first, and have allowed secondary payers, particularly Medicare Advantage Organizations […] Continue