This NAMSAP Corporate Partner featured article is co-authored by Heather Sanderson, CLO, FS Claims Solutions and Jason Lazarus, CEO, Synergy Settlements. Congress created the Medicare Secondary Payer (MSP) program in 1980 to protect the Medicare Trust Fund. Under the...
Just recently, the United States Department of Health & Human Services (HHS) submitted an Amicus Curiae Brief in the Eleventh Circuit in the MSP Recovery Claims, LLC v. Ace American Insurance Company, et al case. A copy of the Amicus Brief can be found here. For...
Insurance Companies and Self-Insureds that process claims for workers’ compensation, liability and no-fault claims (Primary Plans) involving Medicare beneficiary claimants need a better way to obtain information about Medicare Advantage and Part D Drug Plans that may...
Several of our clients have been experiencing an increase in conditional payment letters from Medicare Part D prescription drug plans. Historically, Part D plans have been less active in recovery of conditional payments than traditional Medicare or Medicare Advantage...
What is the intended purpose behind a Workers’ Compensation Medicare Set-Aside (WCMSA)? The WCMSA Reference Guide, Section 3.0 states: “A WCMSA allocates a portion of the WC settlement for all future work-injury-related medical expenses that are covered and otherwise...
Recently, CMS updated its Part D Manual to include specific changes to the Manual’s Medicare Secondary Payer (MSP) provisions. The updated manual can be found here. Page 40 now provides: “Part D sponsors are responsible for adjudicating enrollees’ claims in...
