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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CIGA v. Price – Medicare’s Multiple Diagnosis Code Problem

In January, a California District Court attacked Medicare’s system of lumping related and unrelated diagnosis codes into payments. The problem lays in Medicare’s inflexible recovery system that essentially claims, if one code is related to the sued-for injuries, the entire payment must be repaid to Medicare. We blogged about it in January and noted that…

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Medicare is preparing for LMSAs. Are you ready?

Liability Medicare Set Aside. If you don’t know what an “LMSA” is yet, you’ll need to learn fast. On February 3, 2017, the Centers for Medicare and Medicaid Services (CMS) published Change Request 9893. It establishes new processes for LMSAs and No-Fault MSAs (“NFMSAs”) effective October 2, 2017. CR 9893 is directed to Medicare Administrative…

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Medicare Liens Are Limited

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 Can Recover Payment for Any Alleged Injuries

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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