Medicare
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…
Read MoreMASSIVE’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…
Read MoreCMS 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…
Read MoreDon’t Miss Ryan Weiner, Esq. Tomorrow at the 2022 WILG Longshore Conference!
The 2022 WILG Longshore Conference is featuring MASSIVE’s COO, Ryan Weiner, Esq. as one of the speakers. Ryan is presenting “How Defense Uses Non-Submit MSAs” on Saturday, March 26 and will discuss the complexities of NSMSAs and EBMSAs and offer tips on how to best navigate the new CMS guidelines. Key content includes: Are…
Read MoreMASSIVE 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…
Read MoreThe New Rules of MSAs
Medicare Set-Asides (“MSAs”) don’t exist under the law. CMS insists MSAs are a voluntary process. But – are they truly voluntary? CMS’s recently updated WCMSA User Guide has a new section 4.3 that makes it seem like MSAs are essentially mandatory. The good news is that CMS has laid out all of the reasons…
Read MoreAvoiding Multiple and Duplicate Medicare Files
Medicare can and will open multiple files for a plaintiff’s motor vehicle accident case or workers’ compensation case. In those scenarios, that process is usually correct. In turn, Medicare might open multiple files for a plaintiff’s medical malpractice or other liability case. In this scenario, we think Medicare’s file is probably a duplicate. How do…
Read MoreDon’t Miss the RISE Medicare Secondary Payer Master Class with Ryan Weiner, Esq.!
Only a few days left until the 7th Annual Medicare Secondary Payer Master Class featuring MASSIVE’s COO, Ryan Weiner! Ryan will be co-presenting on how to Understand the Obligations of Plaintiff/Lawyer Related to No-Fault Conditional Payments February 25 at 9:00 a.m. EST and will be welcoming questions for all attendees. Don’t miss this chance…
Read MoreUnderstand the Obligations of Plaintiff/Lawyer Related to No-Fault Conditional Payments
Medicare has five different file designations that can be opened by more than eight different settlement types. It’s possible to have each of those open on one case (if that case is a motor vehicle accident where the plaintiff was at work). So who pays Medicare? And when? Settlement/Payment Type Medicare File Type …
Read MoreWhat is a “Non-Submit” or “Evidence-Based” MSA?
Medicare Set-Asides are a specialized product where Medicare has set forth a special process. The general idea is that an MSA will pay for medical care related to sued-for injuries so that Medicare doesn’t pay. But what happens when the MSA industry decides it wants to cut Medicare from the approval process? Medicare says…
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