Triple Damages and More Uncertainty over LMSAs

by Ben Pugh, JD, Fidelity Fiduciary, LLC and Deborah Watkins, CEO, Care Bridge International, Inc For those of us in the Medicare compliance industry, terms and codes can be confusing. There are two different statutes that can impact a primary payer/ responsible reporting entity (RRE) ...
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NAMSAP MSP Policy Palooza 2017: Recap

The National Association of Medicare Set-Aside Professionals (NAMSAP) conference was outstanding this year, held at the Baltimore, MD Inner Harbor. The speakers offered new insights related to Medicare Secondary Payer issues, professional administration, and case law updates regarding MSP compliance It was exciting to hear ...
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Are Plaintiff’s Lawyers the New Target for Medicare Advantage Plans?

By: Bennett L. Pugh, JD Medicare beneficiaries have a choice.  They can elect to have medical and pharmacy benefits through traditional Medicare under Parts A, B and D. Alternatively, they can opt into a Medicare Advantage Plan (MAP) which represent medical insurers that are allowed to ...
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Medicare Secondary Payer (MSP) Delays or Precludes Settlements 100% of the Time: How Big Data Can Help

We randomly and confidentially surveyed 36 Workers Compensation primary payers, including carriers, third-party administrators, state funds and self-insured entities, and we asked about payer confidence in managing MSP and the greatest challenge posed by MSP. Companies surveyed agreed 100% that MSP compliance delays or interferes ...
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Analytic-Powered MSAs and Why You Want to Use Them!

A Quick Summary of MSP Compliance: Medicare was implemented in 1965 as the primary payer for medical claims involving Medicare beneficiaries not covered by workers' compensation (WC), federal black lung, or veteran’s administration benefits. In 1980, To collect as much money for the Medicare trust ...
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  • When MSP Compliance Survey Results Send You Running for Cover