The Official Medicare Set Aside Blog And Information Resource

Warning: Another Law Firm Reprimanded for Failing to Repay Medicare Conditional Payments

Compliance, Conditional Payments, Medicare Set-Aside Blog, MSP News on January 9, 2020
Posted by Jean S. Goldstein, JD, CMSP

Yesterday, the U.S. Department of Justice’s Attorney’s Office for the Eastern District of Pennsylvania issued a press release stating that another Philadelphia-based personal injury law firm, has entered into a settlement agreement with the United States to resolve allegations that it failed to reimburse Medicare Conditional Payments.  You may recall we saw a similar action […] Continue

CMS to Host Town Hall Meetings to Discuss Medicare Secondary Payer Recovery Topics

CMS, Conditional Payments, Medicare Set-Aside Blog, MSP News on December 5, 2019
Posted by Jean S. Goldstein, JD, CMSP

The Centers for Medicare & Medicaid Services issued an alert today that it will be hosting two town hall meetings to discuss common Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Ongoing Responsibility for Medicals (ORM) and Group Health Plan (GHP) recovery topics. The first town hall will be held on January 14, 2020 at 1:00 […] Continue

CMS Will Maintain $750 Recovery Threshold for 2020

Mandatory Insurer Reporting, Medicare Set-Aside Blog, MSP News on November 27, 2019
Posted by Jean S. Goldstein, JD, CMSP

The Medicare Secondary Payer (MSP) provisions of the Social Security Act prohibit Medicare from making payment where payment has been made or can reasonably be expected to be made by a primary plan.  If payment has not been made, or cannot reasonably be expected to be made promptly by the plan, Medicare may pay for […] Continue

Baltimore-Based Law Firm Repays U.S. Over 90K in Conditional Payments

Medicare Set-Aside Blog, MSP News on November 25, 2019
Posted by Jean S. Goldstein, JD, CMSP

Earlier this month, in a press release, the United States Attorney for the District of Maryland Robert K. Hur announced that a Baltimore-based law firm has paid the United States $91,406.98 to resolve allegations that it failed to reimburse Medicare for conditional payments that had been made to medical providers on behalf of firm clients.  […] Continue

CMS Issues Alert With a Reminder for Non-Group Health Plan Responsible Reporting Entities

Mandatory Insurer Reporting, Medicare, Medicare Set-Aside Blog, MSP News on November 22, 2019
Posted by Jean S. Goldstein, JD, CMSP

While the big news of this week was that the proposed rulemaking due dates for both the rule concerning civil money penalty provisions for Medicare Secondary Payer (MSP) reporting and the rule to address satisfying MSP obligations has been extended once again, CMS also issued an alert this week with an important reminder for Non-Group […] Continue