LexisNexis® Legal Newsroom
CMS Clarifies Guidance on Prescription Drugs and Medicare Workers' Comp Set-Aside Agreements

WASHINGTON, D.C. - The Centers for Medicare & Medicaid Services issued a new memorandum dated May 14, 2010, to clarify guidance in CMS's April 3, 2009 and July 1, 2009 procedure memoranda regarding prescription drugs administered to Medicare beneficiaries for off-lable and/or unlabeled outpatient...

CA: ACIC Supports MSP Resolution, CIGA, Agent Licensing Bills, Opposes Arbitration, Utilization Review Bills

SACRAMENTO , CA – ACIC has posted its weekly bill roundup. Notable workers’ compensation-related bills include: Bills Heard the Week of June 14 Assembly Health Committee – June 15 AJR 42 (Solorio) Medicare Secondary Payer Enhancement Act of 2010. AJR 42 would request Congress...

Five Recent Cases You Should Know About (10/8/2010)

Larson's Spotlight on Medicare Secondary Payer, Increased Risk, Recreational Social Activity, Neutral Risk, and Employment Contract. Larson's surveys the latest case developments that you need to know about. Thomas A. Robinson, the staff writer for Larson's Workers' Compensation Law ...

Jennifer Jordan Interview on The Complete Guide to Medicare Secondary Payer Compliance - A New Handbook Published by LexisNexis

At the 19th Annual Workers' Compensation and Disability Conference & Expo, Las Vegas, NV, attorney Robert Rassp interviewed author and editor Jen Jordan of MedVal on the new handbook The Complete Guide to Medicare Secondary Payer Compliance by LexisNexis . You can view the video here. To read...

Jennifer Jordan Interview on The Complete Guide to Medicare Secondary Payer Compliance - A New Handbook Published by LexisNexis

At the 19th Annual Workers' Compensation and Disability Conference & Expo, Las Vegas, NV, attorney Robert Rassp interviewed author and editor Jen Jordan of MedVal on the new handbook The Complete Guide to Medicare Secondary Payer Compliance by LexisNexis . To order The Complete Guide to Medicare...

The Rassp Report

The Rassp Report, a law blog Robert G. Rassp, Esq. Author, " Lawyer's Guide to the AMA Guides and California Workers' Compensation ," 2012 © Lexis Nexis/Matthew Bender & Co. Chairman of the Board of Directors, Friends Research Institute: www.friendsresearch.org Read...

Leading New York Defense Attorney Endorses LexisNexis Medicare Secondary Payer Book

“ The Complete Guide to Medicare Secondary Payer Compliance (LexisNexis) is a long awaited one-stop resource for the myriad of statutes, regulations, manuals, and memoranda proliferated by the Centers for Medicare and Medicaid Services. Ms. Jordan and her contributors provide concise, practical...

New MSP Reform Bill Proposed in Congress - The SMART Act (H.R. 1063) Proposes New Amendments To the Medicare Secondary Payer Statute

By: Mark Popolizio, Esquire On March 14, 2011, the Strengthening Medicare and Repaying Taxpayers Act of 2011 (SMART Act) ( H.R. 1063 ) was introduced in the U.S. House of Representatives by Tim Murphy (R-PA) and Ronald Kind (DWI). This legislation proposes major amendments to the Medicare...

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...

The U.S. Attorney's Office for the Western District of New York Releases MSP Protocol for Liability Cases

Protocol Establishes "Application for MSP Compromise" Regarding Liability MSA Proposals On May 6, 2011, the United States Attorney's Office for the Western District of New York released a one page document entitled Western District of New York Medicare Secondary Payor Protocol (WDNY...

Wilson v. State Farm: Court Rules That Insurer Did Not Act in “Bad Faith” by Delaying Payment of a Settlement Pending Determination of Medicare’s Conditional Payment Amount

By Mark Popolizio, Esquire, V.P. of MSP Compliance, NuQuest BridgePointe In the case of Wilson v. State Farm Mutual Automobile Insurance Company , No. 3:10-CV-256-H, 2011 WL 2378190 [ 2011 U.S. Dist. LEXIS 63430 ] (W.D. Ky., June 15, 2011), the United States District Court for the Western District...

Medicare Advantage (MA) Plans: Exploring Recovery Rights & Recent Court Decisions

By: Mark Popolizio, Esquire, V.P. of MSP Compliance, NuQuest/Bridge Pointe An emerging area of focus on the Medicare Secondary Payer compliance landscape relates to Medicare Advantage (MA) plans. Interest in this topic has been generated by the claim industry's heightened sensitivity to Medicare...

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...

CMS Will Phase In Implementation of MSP Reporting Requirements for Liability Claims

The CMS has issued policy memorandums stating it will phase in, and not delay, implementation of Medicare Secondary Payer reporting requirement for liability claims, but the insurance industry continues to have concerns about several reporting requirements. Read more from the American Insurance Association...

CMS Announces New "Self-Calculated Final Conditional Payment Amount" Option for Certain Liability Claims

By Mark Popolizio, Esquire Section 111 Senior Legal Counsel Crowe Paradis Services Corporation The Centers for Medicare and Medicaid Services (CMS) will implement a new Self-Calculated Final Conditional Payment Amount option beginning in February 2012 through which Medicare’s “final”...

CMS Announces New "Self-Calculated Final Conditional Payment Amount" Option for Certain Liability Claims

By Mark Popolizio, Esquire Section 111 Senior Legal Counsel Crowe Paradis Services Corporation The Centers for Medicare and Medicaid Services (CMS) will implement a new Self-Calculated Final Conditional Payment Amount option beginning in February 2012 through which Medicare’s “final”...

How California Handles the WCMSA Process

There is a garden industry that has emerged since 1997 in California of companies who have become “WCMSA specialists”, promoting themselves as experts in developing WCMSA proposals that will pass muster with CMS. Most workers’ compensation legal practitioners who represent injured workers...

How California Handles the WCMSA Process

There is a garden industry that has emerged since 1997 in California of companies who have become “WCMSA specialists”, promoting themselves as experts in developing WCMSA proposals that will pass muster with CMS. Most workers’ compensation legal practitioners who represent injured workers...

Court Dismisses Suit Seeking to Hold Carrier Liable for Reimbursing Medicare Payments

By: Mark Popolizio, Esquire In Caldera v. Insurance Company of State of Pennsylvania , No. C-11-321, 2012 U.S. Dist. LEXIS 12888 (S.D. Texas February 2, 2012) a claimant filed a private cause of action claim against the workers’ compensation carrier seeking double damages under the Medicare Secondary...

Recent Medicare Set-Aside Changes

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL, LLC Liability Medicare Set Asides Of the series of memos released by CMS on September 30, 2011, the most notable established a policy for when a liability Medicare set-aside (LMSA) would not be required [ see http://www.cms.gov/COBGeneralInformation...

Recent Medicare Set-Aside Changes

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL, LLC Liability Medicare Set Asides Of the series of memos released by CMS on September 30, 2011, the most notable established a policy for when a liability Medicare set-aside (LMSA) would not be required [ see http://www.cms.gov/COBGeneralInformation...

The Rassp Report

The Rassp Report, a law blog Robert G. Rassp, Esq. Author, " Lawyer's Guide to the AMA Guides and California Workers' Compensation ," 2015 © Lexis Nexis/Matthew Bender & Co. Chairman of the Board of Directors, Friends Research Institute: www.friendsresearch.org Read...

Federal: Bankruptcy Trustee Has No Claim to Worker’s MSA Held in Bank Account

A Federal Bankruptcy Court in Pennsylvania has held in relevant part that a Medicare Set-Aside is not subject to administration by a bankruptcy trustee because it is not property of the bankruptcy estate in spite of the fact that it might be held in a personal bank account maintained by the Chapter 7...

Workers’ Compensation and Its Secondary Payers: Medicare and Medicaid

Last November I had the pleasure of participating in a panel with two more eminently qualified folks—Jennifer C. Jordan of MEDVAL, LLC and Tim Nay at Nay & Friedenberg —about Medicare Secondary Payer (MSP) compliance at the 23rd Annual National Workers’ Compensation and Disability...

Opt Outs to Workers’ Compensation: The Real Disconnect in What Is Being Said and What Is Being Implemented

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL, LLC The National Workers’ Compensation and Disability Conference generally serves as a pretty good barometer of what the industry focus will be in the upcoming year and it is evident that 2016 will be all about opt-out. Given that it was...