2011 Alphabet Soup: MSA, CMS, WCMSA, MSPRC, COBC, C&R, RRE, ORM, TPOC, EIEIO - The Latest in Medicare, Social Security and Your Large C&R in California

By Robert G. Rassp, Esq. Yes, so, the last one is a joke – Old MacDonald had a farm… We have recently traveled all over the country talking about and listening to the effect CMS has had on all of the stakeholders in the entire workers’ compensation community and not just in California...

“Off Label” Uses of Medical Products and Services

By Vernon Sumwalt, Esq. Under most workers’ compensation programs, coverage for medical treatment differs from the coverage afforded by other plans. For example, state workers’ compensation programs often cover “reasonable and necessary” medical expenses related to an injury...

Delay in Calculating a Structured MSA Can Cost You, It’s Free, So Why Wait?

By Teddy Snyder, Esq. I got the call again. I’m in California, but this case closure scenario can happen anywhere. “I have a signed C&R for $46,000 with CMS approval. Can you save me some money?” The answer is “Probably, but it will be more complicated, because you waited...

Medicare Secondary Payer Charitable Foundation Announces Free Professional Medicare Set-Aside Administration for Qualified Beneficiaries

August 22, 2011 – Columbia, MD. The Medicare Secondary Payer Charitable Foundation (MSPCF), a newly founded not-for-profit organization, announces that it will provide free professional Medicare Set-Aside Administration nationwide for qualified beneficiaries beginning October 1, 2011. The foundation...

Determining Medicare Status - Assessing CMS’ Query Process System in the Bigger Picture of MSP Compliance

By Mark Popolizio, Esquire, Section 111 Senior Legal Counsel, Crowe Paradis Services Corporation Determining a claimant’s Medicare status is an integral part in evaluating one’s compliance obligations under the Medicare Secondary Payer Statute (MSP). When a claimant is identified as a Medicare...

Determining Medicare Status - Assessing CMS’ Query Process System in the Bigger Picture of MSP Compliance

By Mark Popolizio, Esquire, Section 111 Senior Legal Counsel, Crowe Paradis Services Corporation Determining a claimant’s Medicare status is an integral part in evaluating one’s compliance obligations under the Medicare Secondary Payer Statute (MSP). When a claimant is identified as a...

Four Reasons to Avoid the CMS Approval Process for MSAs

By Teddy Snyder, Esq., Ringler Associates - Beverly Hills, CA 1. MMSEA reporting makes approval unnecessary for Medicare beneficiaries. Reporting under the Medicare, Medicaid and S-Chip Extension Act, aka “section 111 reporting”, started January 1, 2010 for workers compensation claims...

Four Reasons to Avoid the CMS Approval Process for MSAs

By Teddy Snyder, Esq., Ringler Associates - Beverly Hills, CA 1. MMSEA reporting makes approval unnecessary for Medicare beneficiaries. Reporting under the Medicare, Medicaid and S-Chip Extension Act, aka “section 111 reporting”, started January 1, 2010 for workers compensation claims...

California WCMSA Case: Did Clinical Need for Medical Treatment Occur Faster Than CMS Process for Approving Medicare Set-Aside?

By Jennifer C. Jordan, Esq. In California, there is a unique trend compared to the rest of the nation in that the Medicare Set-Aside process is primarily defense driven with less than full disclosure to the Applicants. While not applicable to all employers/insurers, it is problem enough that the Applicant's...

California WCMSA Case: Did Clinical Need for Medical Treatment Occur Faster Than CMS Process for Approving Medicare Set-Aside?

By Jennifer C. Jordan, Esq. In California, there is a unique trend compared to the rest of the nation in that the Medicare Set-Aside process is primarily defense driven with less than full disclosure to the Applicants. While not applicable to all employers/insurers, it is problem enough that the Applicant's...

Illinois Court Permits Ex-Wife to Take a Percentage of MSA Account as Part of Divorce Action

By: Mark Popolizio, Esquire, Crowe Paradis Services Corporation In the case of In re Marriage of Washkowiak , 2012 Ill. App. Lexis 151 (Ill. App. 3 Dist., March 7, 2012) the Illinois Appellate Court ruled that a claimant’s former wife was entitled to receive 17.5% of the funds from his Medicare...

The WCMSA Conundrum in California

By Robert G. Rassp, Esq. The following email string is true, accurate and correct. It is a typical email string between an applicant’s attorney and a defense attorney. We all have cases like this in our inventories. In this case, the Applicant was a medical laboratory technologist who sustained...

The WCMSA Conundrum in California

By Robert G. Rassp, Esq. The following email string is true, accurate and correct. It is a typical email string between an applicant’s attorney and a defense attorney. We all have cases like this in our inventories. In this case, the Applicant was a medical laboratory technologist who sustained...

Delaware IAB Enforces MSA Commutation Where Surgery Is Proposed After the Fact...and a Cupcake

Today's post is a pretty dry discussion by Sassy Cassy standards. I stumbled across a recent Motion Day ruling that presents a potentially novel issue and has a little something to offer on the topic of enforceability of settlements. That and the whole spectrum of issues presented by commuting medicals...

Delaware IAB Enforces MSA Commutation Where Surgery Is Proposed After the Fact...and a Cupcake

Today's post is a pretty dry discussion by Sassy Cassy standards. I stumbled across a recent Motion Day ruling that presents a potentially novel issue and has a little something to offer on the topic of enforceability of settlements. That and the whole spectrum of issues presented by commuting medicals...