The Official Medicare Set Aside Blog And Information Resource

Shark Week and MSP Compliance: What Do They Have In Common?

CMS, Conditional Payments, Medicare Set-Aside Blog, Medicare Set-Asides, MSAs on August 14, 2020
Posted by Jean S. Goldstein, JD, CMSP

Shark Week is always a magical week; providing enthralling and illuminating insight into jaw-dropping actions of magnificent beings.  As with previous years, Shark Week 2020 has not been a disappointment, but how does shark week compare to Medicare Secondary Payer (MSP) compliance?  Our latest white paper addresses the three main goals of MSP compliance, and what consequences result for […] Continue

A New User Guide and New Functionality Added

Conditional Payments, Medicare Secondary Payer Recovery Portal, Medicare Set-Aside Blog on July 13, 2020
Posted by Jean S. Goldstein, JD, CMSP

Last month, we blogged about new functionality to the Medicare Secondary Payer Recovery Portal (MSPRP) to allow authorized users to view and print correspondence via the portal, which is now accessible.  This is beneficial when correspondence related to the conditional payment recovery process has not been received.  In addition, today, a new MSPRP User Guide […] Continue

MSP Court Decision Sends Warnings Signals to Primary Payers

Conditional Payments, Medicare Set-Aside Blog, MSP Litigation on July 7, 2020
Posted by Jean S. Goldstein, JD, CMSP

A recent decision out of the United States District Court for the District of New Jersey is sending warning signals and a reminder to implement proactive practices to primary payers. The decision arises from Osterbye v. United States, 2020 U.S. Dist. LEXIS 116591, and came before the court on the Defendant’s Motion to Dismiss Plaintiff’s […] Continue

Conditional Payments Continue; Designating a Recovery Agent Could Help

CMS, Conditional Payments, Medicare Set-Aside Blog on May 26, 2020
Posted by Jean S. Goldstein, JD, CMSP

In the face of the pandemic, which continues to impact our daily lives, one thing remains constant:  conditional payments. A conditional payment occurs when Medicare makes a payment on behalf of a beneficiary for medical treatment services when payment should have been made or reasonably could be expected to be made by a primary payer. To […] Continue

Will the Expansion of Telehealth Services Lead to More Conditional Payments?

CMS, Conditional Payments, Medicare Set-Aside Blog, Telehealth on March 30, 2020
Posted by Jean S. Goldstein, JD, CMSP

In 2019, Medicare started covering some virtual care services. The services covered included brief communications and Virtual Check-Ins (short patient-initiated communications with a healthcare practitioner) along with E-visits (which are non-face-to-face patient-initiated communications through an online patient portal). However, telehealth services have generally not been covered. Historically, for telehealth services to be covered, certain circumstances […] Continue