As we previously reported, a CMS policy for liability Medicare set-aside (LMSA) review appears to be imminent. The current state of confusion is depicted in a recent case involving CMS. In Silva v. Burwell, the plaintiff was injured as a result of a medical malpractice incident, after which he sustained permanent and extensive brain damage … Continue reading Will workers’ compensation MSA guidelines extend to personal injury cases?
CMS
Will workers’ compensation MSA guidelines extend to personal injury cases?
As we previously reported, a CMS policy for liability Medicare set-aside (LMSA) review appears to be imminent. The current state of confusion is depicted in a recent case involving CMS. In Silva v. Burwell, the plaintiff was injured as a result of a medical malpractice incident, after which he sustained permanent and extensive brain damage…
Will workers’ compensation MSA guidelines extend to personal injury cases? was originally published on Inman Fitzgibbons, Ltd.
Understanding Medicare’s Secondary Payer Private Cause of Action against Primary Payers
As a “secondary payer,” Medicare has an interest in any workers’ compensation claims where it may have paid for medical care that might be related to the workers’ compensation injury. Medicare calls payments it makes to a Medicare beneficiary “conditional payments.” The condition is that Medicare will seek reimbursement for the payments made if it … Continue reading Understanding Medicare’s Secondary Payer Private Cause of Action against Primary Payers
A CMS Policy for LMSA Reviews is Imminent
The Centers for Medicare & Medicaid Services (CMS) recently issued documentation signaling that Liability Medicare Set-Asides (LMSAs) and No-Fault Medicare Set-Asides (NFMSAs) will be notated fields in CMS’ Common Working File. Effective October 1, 2017, Medicare Administrative Contractors will begin denying payment for services associated with an open LMSA or NFMSA record. The CMS Manual Update … Continue reading A CMS Policy for LMSA Reviews is Imminent
CMS Database Brings Transparency to Payments made to Doctors
As our employer and insurance industry clients are well-aware, skyrocketing medical costs have greatly contributed to rising exposure and expense in workers' compensation claims. Often, respondents in workers' compensation claims are in the dark as to the doctors' motivation for prescribing a given course of care. Although opinions certainly differ as to the 2010 Affordable … Continue reading CMS Database Brings Transparency to Payments made to Doctors
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