B. Josh Pettingill, MBA, MS, MSCC Vice President of MSP Compliance The “law” as it relates to Medicare Set Asides in liability settlements is an evolving area with new developments happening quite frequently. This year there have already been several noteworthy legal decisions pertaining to the protection of Medicare’s future interest in liability settlements. Below […]
Insurance carriers are bringing up the Medicare set aside (MSA) “issue” when it comes time to draft the release more frequently. In many instances, the plaintiffs are not yet eligible for Medicare benefits, nor may they ever be entitled to receive Medicare benefits. Plaintiff attorneys need to proceed with caution with regard to the Medicare […]
The Centers for Medicare & Medicaid Services (CMS) has officially withdrawn their Notice of Proposed Rulemaking (NPRM) for protecting Medicare’s future interests with respect to future medicals. The NPRM was originally submitted to the Office of Management and Budget (OMB) back in August 2013. With the NPRM, it was anticipated CMS was going to establish […]
In a well reasoned opinion, the Florida Supreme Court has overtuned the unfair medical malpractice caps. These caps devalued human life as children and seniors who were not breadwinners, could be the victim of malpractice with no real ability for family members to recover damages. We applaud the Florida Supreme Court’s opinion in the McCall […]
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In a case of first impression at the Federal District Court level, a United States
District Court in the Western District of Louisiana apportions a LMSA and
reduces it due to a limited recovery.
On 9/29/11, CMS issued a memorandum indicating there is no need for a liability Medicare set aside and that its interests would be satisfied if the treating physician certifies in writing that treatment for the alleged injury related to the liability insurance has been completed as of the date of settlement.
In the first memo coming from CMS HQ regarding Liability Medicare Set Asides, Charlotte Benson, Acting Director Financial Services Group for CMS, gives us an exception to the need to create a set aside. According to the memo, a liability Medicare set aside isn’t necessary when the Medicare beneficiary’s treating physician certifies in writing that all of the care related to the claimed injury has been completed as of the date of the settlement.
CMS Region 6 issued a memorandum on liability Medicare set asides (“LMSA”) which has some useful information but has limited application outside of Texas, Oklahoma, New Mexico, Louisiana and Arkansas.