Our Blog

MSP Manual Update Puts MSAs into Motion at Provider Level

A recent change to a Medicare Secondary Payer Manual brings Medicare Set-Asides into play for doctors and other medical service providers, who as of March 24 are obligated to direct bill those trusts. Just a year after Medicare’s Workers’ Compensation Medicare Set-Aside Reference Guide update strenuously emphasized the utility of MSAs in protecting Beneficiary entitlements post settlement, the Centers for Medicare and Medicaid Services now put MSA policy in motion with this recent directive. This change is consistent with Medicare’s WCMSA policy and previous guidance that allocations of future medical expenses should be properly funded and spent down in order to protect entitlements. Previous versions of this Manual illustrated primary insurance as opposed to secondary insurance, but made no specific reference to Medicare Set-Asides.
Read more

MD Law Firm Settles with DOJ for Failure to Reimburse Conditional Payments

In a recent publication, the U.S. Attorney’s Office for the District of Maryland has confirmed that a Baltimore-based firm – Kandel & Associates, P.A. has entered into a settlement agreement to resolve alleged claims that the firm failed to reimburse Medicare for conditional payments made by CMS on behalf of firm clients. The claims against Kandel allege that over several years, the firm received settlement proceeds on behalf of its clients but neither the firm nor its clients reimbursed Medicare for conditional payments. The USAO has identified at least twelve Medicare liens that went unresolved.
Read more

Practice Alert: CMS Address Change

Effective March 13, 2023, the Centers for Medicare and Medicaid Services has issued an announcement that the mailing address has changed for Medicare’s Commercial Repayment Center (CRC). The CRC handles all liens for cases wherein Medicare considers the insurer/employer to be the debtor.
Read more