Medicare Suggests LMSAs and NFMSAs are on the Horizon. Again.

Medicare via HHS/CMS has once again put us on notice that Medicare Set-Asides may expand to liability and no-fault scenarios with LMSAs and NFMSAs. It recently released a Notice of Proposed Rule Making with a due date of February 2022. You can find the NPRM here.   Could that mean CMS will finally create rules…

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Medicare Set-Aside Basics

Medicare Set-Asides (or “MSAs”) are a construct created because the Medicare Secondary Payer Act makes it illegal for Medicare to pay for case-related treatment. Of course, this is limited to circumstances where a primary payer exists, such as a Workers’ Compensation carrier, a No-Fault carrier, or a liability defendant. But MSAs don’t exist under the law. They…

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How Many Files Can Medicare Open for One Lawsuit?

Most lien holders have one file for all of an individual plaintiff’s settlements. Medicare can have multiple for each of an individual plaintiff’s settlements.   Medicare’s process has its roots in something called Section 111, or Mandatory Insurer Reporting. That law requires all defendants notify Medicare of payments they make, whether they are paying voluntarily…

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Medicare’s Agents: CMS, BCRC, and CRC

For Medicare Liens, the agency is represented by one branch of the government and two contractors. Those actors are: CMS – the Centers for Medicare and Medicaid Services. CMS is the government agency involved in Medicare Liens and works beneath Health and Human Services of the Executive Branch; BCRC – the Benefit Coordination & Recovery…

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2022 Medicare Recovery Thresholds

CMS has announced Medicare lien minimum recovery thresholds for 2022 settlements. Those thresholds are unchanged for the sixth straight year. These minimum settlement amount recovery thresholds essentially create a safe harbor for the smallest of settlements (excluding settlements that include exposure-based injuries). You can find that CMS alert here.   Here are some highlights: Plaintiffs…

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Oklahoma Plaintiff’s Medicare Lien Fully Waived by MASSIVE

MASSIVE ensured an Oklahoma Plaintiff was able to take home her full net settlement despite a Medicare lien that was more than ten times the settlement amount.   The plaintiff was a part of a mass tort Genzyme Hernia Mesh claim. The lien amount was over $100,000 and not part of a global resolution, which…

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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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Post-Settlement Conditional Payment Resolution with the BCRC

Post-Settlement Conditional Payment Resolution with the BCRC

The Benefit Coordination and Recovery Contractor, or BCRC, is the recovery agent for Medicare liens. Understanding BCRC processes is the key to a smooth post-settlement disbursement process. And with Medicare coverage increasing to nearly 20% of the population, the BCRC’s processes matter more than ever.   But there’s another important player: the Commercial Repayment Center,…

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MASSIVE at the 2021 AAJ Annual Convention

We are proud to announce MASSIVE’s continued support of AAJ for the upcoming 2021 AAJ Annual Convention July 12-15 at The Cosmopolitan of Las Vegas. We are excited to be a sponsor for the Incoming President Party. This is sure to be one of the many highlights at AAJ’s first in-person convention in 17 months!…

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