Tag Archive | Medicare Reform
SMART Act: Final/Conditional Medicare Lien Process
Looking back at yesterday’s SMART Act post it is hard to decipher how to properly obtain what we are calling a “Final Conditional” Amount or Lien. We hope the following workflow (including our assumptions and expectations of the future process) will help: T-120 days to settlement – Send an Expected Settlement Notice to the MSPRC; […]
SMART Act: Is Medicare Lien Resolution Smarter Now?
On January 10, 2013, President Obama signed H.R. 1845. Included on the Medicare IVIG Access Bill is the SMART Act. SMART was designed to reform the conditional payment, final demand, and MMSEA Section 111 reporting processes. Click here to read the full text of H.R. 1845. As you can see below, we aren’t as excited […]
House & Senate Pass Medicare’s SMART Act
Both the House and Senate passed the SMART act prior to the Christmas holiday last week. In the House just 3 “no” votes were cast against 401 “yes” votes. The Senate passed the act without a single “no” vote. There is little doubt that President Obama will sign the bill into law. What is the […]
AAJ Working Toward 2nd Circuit Allocation of Medicare Lien
The AAJ sent out an update regarding a case where it is attempting to win a major victory for Medicare beneficiaries. The plaintiffs are using Bradley v. Sebelius to try to convince a probate court to allocate the settlement funds and reduce Medicare’s lien. The AAJ writes, In Bradley, the probate court ordered an apportionment […]
LRS Public Comment: CMS-6047-ANPRM – CMS Proposed Rules for Liability Medicare Set-Asides
As you should know, Medicare has taken its first steps toward requiring Medicare Set-Asides in all personal injury cases. On June 15, 2012, it (via CMS and HHS) posted a request for public comment on rules it hastily created for a potential LMSA system. Our initial analysis of the federal register posting from June 15 […]
Federal Register – June 15, 2012: Advanced Notice of Proposed Rulemaking (LMSAs)
The Friday, June 15, 2012 Federal Register includes a four-page request for public comment requested by the Department of Health and Human Services’ Centers for Medicare & Medicaid Services. The comment is requested for potential changes to 42 CFR Parts 405 and 411 and is titled, “Medicare Program; Medicare Secondary Payer and ‘Future Medicals.’ “ […]
Liability MSA (LMSA) Cases Cited by the MSA Industry
Many of those involved in the MSA industry (including CMS officials) point to “LMSAs” being approved by Federal District Courts. These cases are circulated on listservs and message boards as reminders that LMSAs may be necessary in certain cases. These cases all carry one extra piece of information worth noting: the underlying injuries were the […]
The Congressional Failure to Understand Medicare
Congressman Dennis Ross (Republican – Lakeland, Fl) spoke to the National Association of Medicare Set Aside Professionals (“NAMSAP”) convention on Friday, March 30, 2012. Congressman Ross’s topics were Medicare liens and Medicare Set-Asides. Note: I started this post as a recap of Congressman Ross’ talk with NAMSAP – but it turned into an 1111 word rant […]
New MSPRC Procedures on $5,000 Settlements
Direct from the MSPRC website – Medicare liens on $5000 settlements (or less) have a secondary lien resolution option: New Fixed Percentage Option For Medicare’s Recovery Claim The Centers for Medicare & Medicaid Services will be implementing a new and simple fixed percentage option that will be available to certain beneficiaries beginning November 7, 2011. […]
Update: New Medicare RRE Reporting Guidelines
On September 30, 2011 the Centers for Medicare and Medicaid Services (“CMS”) revised its Mandatory Insurer Reporting timelines – again. The difference between this change and the previous revisions and moratoriums is that certain cases must be reported. Which cases? Funny you should ask: The only cases that must be reported are those with total […]
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