MSAs and Reversionary Interests

Doctor with Stethoscope

Workers Compensation attorneys know the biggest trend in MSAs has little to do with the MSA itself. That trend, of course, is the reversionary interest that says unused funds will revert to the insurance carrier’s control if the claimant/plaintiff passes away. So what does Medicare think of reversionary interests?   Nothing.   Medicare has no…

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MASSIVE’s Ryan Weiner Speaking at the MSA Roundtable during KTLA’s Workers Compensation Section

Ryan Weiner, COO of MASSIVE, will be presenting at the Medicare Set-Asides Roundtable on Friday, December 10, 2021, from 2:30 – 3:30 p.m. (CST).    Key content to be discussed at the Medicare Set-Asides Roundtable includes:  The Do’s and Don’ts of MSAs and EBMSAs  How to protect the Client on a MSA Proposal  30-minute Q & A Session    Attendees must register and be a member of the KTLA Workers Compensation Section. 

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Medicare Set-Aside Basics

Medicare Set-Asides (or “MSAs”) don’t exist under the law. Nevertheless, nearly all Workers’ Compensation cases, and a growing number of Liability cases, consider whether an MSA is needed.  If MSAs don’t exist under the law, why do I need one? MSAs come from the Medicare Secondary Payer Act. 42 U.S.C. § 1395y(b)(2) and § 1862(b)(2)(A)(ii) of…

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Lien Resolution & MSP Compliance CLE *register today*

Join us tomorrow as we partner with Ametros & WILG to learn* about solutions in claims resolution, MSP compliance, and professional administration. *CLE Credit available in selected states. Topics will include: • New Requirements in Medicare Consent to Release Forms: Beginning on April 1, 2020, the Centers for Medicare & Medicaid Services (CMS) will require…

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Liability Medicare Set-Aside Requirements

do you need an msa

The General “Requirements” of an LMSA: A Technical Review Medicare Set-Asides (“MSA”) cannot exist without Medicare’s right to reimbursement first being stated in the law. Those rights arise from the Medicare Secondary Payer Statute, 42 U.S.C. § 1395y(b)(2) (“MSP”) and 42 C.F.R. 411 et. seq. Then we must note that, MSP regulations and Centers for…

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Medicare Set-Asides in California

NEWS

California Applicant Attorneys Can Petition for Reimbursement for Costs Associated with Medicare Set-Asides (MSA). Specific language regarding reimbursement of an Medicare Set-Asides is found under Petition of Costs in Section 10545 (formerly section 10451.3): (a) Petition for costs is a petition seeking reimbursement of an expense or payment for service not allowable as a lien…

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Medicare to Pay for Acupuncture to Lower Opioid Use

medicare to pay for acupuncture

CMS announced a coverage determination that will allow Medicare to pay for acupuncture that treats chronic low back pain. This new coverage is highly consequential in the legal industry as the stated purpose is to expand options that reduce opioid use. Opioids just so happen to be a major expense in Medicare Set-Asides (MSAs). Health…

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Trostle v. Centers for Medicare and Medicaid Services: Part III

Trostle v Medicare

Trostle v. Medicare Part III This is the third and final part in our case study on Trostle v. Centers for Medicare and Medicaid Services. We initially explained the underlying lawsuit, Medicare’s lien, and Mr. Trostle’s attempts to fight the lien arguing detrimental reliance in Part I. Then, we dove into the more recent case…

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Trostle v. Centers for Medicare and Medicaid Services: Part II

Trostle v. Medicare: Part II Previously, we wrote about and analyzed Trostle v. Centers for Medicare and Medicaid Services. Following dismissal for lack of jurisdiction, this Medicare lien litigation continued with a counter-suit by the United States government. Part II of our case study will explore errors made that caused the government to react with…

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