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 bill failed and never made it out of the Committee on […] Continue
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
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
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
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
MEDVAL’s blog, The Official Medicare Set Aside Blog And Information Resource, has been selected as the best blog in the Medicare Secondary Payer Industry by workerscompensation.com. We sincerely want to thank all of our loyal readers who took a moment to nominate us, as well as the esteemed panel of judges for this prestigious accolade. It […] Continue
Last week, Congressman Gus Bilirakis and Congressman Ron Kind introduced legislation (H.R. 5881) in the House of Representatives to amend title XVIII of the Social Security Act, specifically in an effort to provide for transparency of Medicare Secondary Payer (MSP) reporting information. Congressman Bilirakis issued a press release yesterday stating that, “[t]his legislation will ensure […] Continue
Last month, Arizona Governor, Doug Ducey signed Senate Bill 1100 (SB 1100), which is a modification to the legislation allowing for full and final settlements.[1] You may recall our initial blog on the ability to finally fully settle and close out a workers’ compensation claim in Arizona, under Senate Bill 1332 (SB 1332), as well […] Continue
The Centers for Medicare & Medicaid Services (CMS) recently issued a revised self-administration toolkit, version 1.2. The purpose of the toolkit, just as with the previous version is outlined on page 3 of the 31 page guide, which is to describe the Workers’ Compensation Medicare Set-Aside (WCMSA) self-administration process and provide guidelines for claimants. Specifically, […] Continue
The Centers for Medicare & Medicaid Services (CMS) through various Memorandums and guides, has clearly stated that “[w]hile there are no statutory or regulatory provisions requiring that a (Workers’ Compensation Medicare Set Aside) WCMSA proposal be submitted to CMS for review, submission of a WCMSA proposal is a recommended process.” Of significant note, the word […] Continue