Medicare compliance should be a part of every injury firm’s business plan. Need proof? Take a look at this press release from the US Attorney’s Office for the Eastern District of Pennsylvania. Want more proof? Read the settlement agreement between the US Attorney and Philadelphia personal injury law firm Rosenbaum & Associates for nine unpaid…

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We received this question directly from a plaintiff last week (who also happens to be a practicing attorney): Can Medicare claim its reimbursement right where the case is only a Wrongful Death action? Answer: Maybe. Three Medicare cases help us get to the analysis. First there was Bradley v. Sebelius (621 F.3d 1330, 11th Cir.…

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Please remember Medicare liens for what it considers No-Fault and Workers’ Compensation files may not change for a few days. Performant Recovery, Inc. officially takes over tomorrow, February 8, 2018; however, CGI is handing off all data beginning today, February 7, 2018. All CRC files will re-start processing (mail, faxes, etc.) on Monday, February 12, 2018.…

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As we’ve previously discussed, Medicare’s CRC contractor is changing from CGI to Performant Recovery, Inc. on February 8, 2018. The CRC is having three days of what it is calling it’s, “Dark Days” from February 7 thru 9, 2018. What does this mean? Medicare No-Fault and Workers’ Compensation files will be accessible, but, no additional…

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CMS announced that it will begin moving away from its current ID system. That system has long relied on Social Security Numbers as the basis for Medicare’s “Health Insurance Claim Number” or HICN (its name for what we refer to as the Medicare number). While this change is a major positive step toward reducing identity theft,…

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Two weeks ago, a California District Court ruled that Medicare can only seek reimbursement for items and services related to the underlying claim. Logical? Sure. But there’s more to it! First, the Court took on Medicare’s combination of ICD-9 or ICD-10 codes into one payment. Second, the Court reminded us all that Medicare’s claim is…

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Medicare liens driving you to the edge? MASSIVE can help – here is just one example of our outstanding results for plaintiff attorneys: Paul Beechen, a Los Angeles, CA attorney, recently utilized MASSIVE to help his client with a Medicare lien of over $120,000.   MASSIVE was able to step in and successfully reduce the lien…

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Anderson v. Burwell gives us another example of Medicare’s powerful abilities to recover Medicare liens (or more accurately, Medicare Conditional Payments). The U.S. District Court for the Eastern District of Michigan, Southern Division, decided on March 3, 2016 that any care claimed as related to negligence is recoverable by Medicare. That recoverability is not earth-shattering,…

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Attorneys are individually liable to Medicare if they receive a settlement or payment on behalf of a Medicare beneficiary. US v. Harris, 2009 US Dist. LEXIS 23956 (N.D. W. Va. 2009). It’s that simple: make sure Medicare gets repaid for its lien. If you don’t: they can come after you. A new case in a…

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