Medicare Liens in Workers’ Compensation

Medicare’s process in Workers’ Compensation is generally misunderstood. The best solution? Remember that Medicare will attempt to collect from any source and any settlement.   Medicare will open files relating to a Workers’ Compensation injury in the following manner:  Recovery from the carrier. This file is via the Commercial Repayment Center (“CRC”). We can call…

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Medicare Compliance for Plaintiff Attorneys

The federal government enacted the Medicare Secondary Payer Act in 1980. Since then, it has gone from a toothless idea to recoup money, to a convoluted beast affecting past and future medical payments in all settlements. What areas of the law are most concerning?   Medicare Conditional Payments. Essentially, a “Conditional Payment Letter” from Medicare…

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MASSIVE’s Ryan Weiner to speak at Kansas Annual Workers’ Compensation Seminar on September 28, 2022

Ryan Weiner, Esq., COO of MASSIVE, will be presenting “Medicare Lien Resolution in Workers’ Comp Claims” at the virtual Kansas Department of Labor’s 48th Annual Workers Compensation Seminar Wednesday September 28th at 2:20pm (CST).   Key content to be discussed includes:  Understanding who is the “debtor” in Medicare’s view  Analyzing the process from plaintiff perspective…

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Plaintiff and Defense Cooperation in Medicare Liens

Most settlement agreements miss a vital series of terms that all defendants must report to the government. Those terms are used in Medicare’s Section 111 reporting. They include what date of incident is being reported to Medicare, a clear statement of the settlement amount being reported to Medicare, and injury codes being reported.   Sure,…

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Play by the Rules with Medicare Liens

Medicare Lien Resolution

The US Department of Justice is suing law firms who do not pay their clients’ Medicare liens.   Medicare is diligently monitoring firms to make sure their liens are reimbursed fully and timely. There are many examples of Medicare notifying the US Department of Justice when their liens have been ignored. The results are the…

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Medicare’s Anti-NSMSA and EBMSA Stance

Medicare does not consider Non-Submit Medicare Set-Asides (NSMSAs) or Evidence-Based Medicare Set-Asides (EBMSAs) as true MSAs. Its announcement came in January with a surprise WCMSA Reference Guide 3.5 release (a new version 3.6 now exists). This surprise includes Section 4.3 which states, “CMS treats the use of non-CMS-approved products as a potential attempt to shift…

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MASSIVE’s Ryan Weiner, Esq. to present at the 6th Annual MSP Conditional Payment Forum July 11-13, 2022

Ryan Weiner, COO of MASSIVE and long-time authority on liability, no-fault, and workers’ compensation conditional payments, is presenting at the virtual 6th Annual Medicare Secondary Payer Conditional Payment Forum on July 12 at 11:55AM EST. Ryan will be discussing conditional payments resolution in no-fault claims.   Key content to be discussed includes:  Identify if the…

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CMS Guidance on WCMSA’s Section 4.3

We like to remind the legal industry that Medicare Set-Asides (“MSAs”) don’t exist under the law. They’re a very good idea considering the consequences to a claimant or plaintiff of not having an MSA.   Remember that CMS’s recent update to the WCMSA User Guide has a new section 4.3 with CMS warning us of…

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MASSIVE Completely Resolves Medicare Lien for Connecticut Plaintiff

A Connecticut man received a delayed diagnosis of parotid cancer. This is an aggressive form of cancer and can be terminal. However, if caught early, life expectancy can be prolonged with early intervention.   MASSIVE’s experts established that the treatment on his lien was medically necessary for the plaintiff’s cancer care and would have occurred…

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