Main Synergy InSights Blog Category
In WOS v. EMA, the first case to reach the US Supreme Court after Ahlborn, the highest Court in the land again examined a state statute requiring up to one-third of any damages recovered by an injury victim to be paid to the state to reimburse it for payments made by Medicaid for injury related treatment.
Are the defendants/insurance carriers throwing everything but the kitchen sink into your release language in regards to protecting Medicare’s interests?
Learn more about the Medicare recovery process under the MSP.
On December the 19th the Strengthening Medicare Secondary Payer Rules Act was passed by the House. The Senate passed the Act on December the 21st. It is on its way to President Obama to sign. While it modifies the Medicare Secondary Payer Act, it only streamlines the MSP conditional payment process and has nothing to do with Medicare Set Asides.
With Medicare Secondary Payer (“MSP”) Compliance on everyone’s minds these days, it is no wonder that MSP vendors have tried to capitalize on these fears by offering services targeting them. The problem is that some of these vendors may be doing more harm than good.
The MSPRC announced a new option to self calculate a conditional payment amount to submit for approval if the settlement is $25,000 or less.
Some individuals are dual eligible. In plain English, this means they qualify for both Medicaid and Medicare. In certain cases, a Medicare Set Aside/Pooled Trust Sub-Account may be necessary to preserve the dual eligibility.
On June 27th, Medicare formally resumed issuing demand letters after it halted issuance in response apparently to the Haro v. Sebelius decision. I will summarize what is new in the demand letter.