November 12, 2020
By: Rasa Fumagalli, JD, MSCC, CMSP-F
The Centers for Medicare and Medicaid Services (CMS) has been slow in providing detailed guidance in the area of liability settlements that include compensation for future medicals. To date,…

November 10, 2020
Mrs. Smith was moved to the ICU and no neurologic monitoring was performed that evening after being moved from the surgical suite. The next morning, Mrs. Smith was found to be quadriparetic. A suit was brought against…

November 4, 2020
John Doe was a laborer since age eighteen, but when he was thirty, he was severely injured and became paralyzed. John didn’t have health insurance at the time of his accident, and the hospital applied for Medicaid…

October 27, 2020
For many years, personal injury cases have been resolved without consideration of Medicare’s secondary payer status even though since 1980 all forms of liability insurance have been primary to Medicare. At settlement, by judgment or through an…

October 21, 2020
By now, most workers’ compensation practitioners are familiar with the Centers for Medicare & Medicaid Services (CMS) voluntary review process involving Workers’ Compensation Medicare Set-Aside Arrangements (WCMSA). CMS is currently willing to review settlements that exceed $25,000.00…

October 20, 2020
Heidi Ahlborn was injured in a very serious car accident in January of 1996. At the time, she was a nineteen-year-old college student pursuing a degree in teaching. She suffered a catastrophic brain injury that left her…

October 13, 2020
As of April 1, 2011, a Responsible Reporting Entities/insurers (RRE), (liability insurer, self-insurer, no-fault insurer, and workers’ compensation carriers) must determine whether a claimant is a Medicare beneficiary (“entitled”) and if so, provide certain information to the…