The Plaintiffs Source for MSP Compliance Solutions

Posts Tagged ‘Liability’

This Just In: MSPRC Announces $300 Threshold in Liability Cases

Wednesday, September 7th, 2011

A new alert was posted on the MSPRC.info website on September 6, 2011.  The MSPRC has announced a $300 threshold in liability cases that qualify based on the type of incident and settlement distribution. 

From www.MSPRC.info:

Beneficiary Alert: $300 Threshold on Liability Settlements

Medicare has implemented a $300 threshold for certain Liability Insurance cases. If all of Medicare’s criteria are met, the MSPRC will not recover against the beneficiary’s settlement, judgment, award or other payment.

If you’re a beneficiary, what does this mean for you?

As of September 6, 2011, if you’ve received a lump sum settlement of $300 or less, and your case meets certain conditions, Medicare will not recover from that settlement. These conditions include:

  1. Your settlement is related to an alleged physical trauma-based incident, not an alleged exposure, ingestion, or implantation, and
  2. You do not have any additional settlements related to the same alleged incident.

Please note that this threshold specifically excludes settlements where an insurer is paying your medicals bills directly or on an ongoing basis. This threshold also does not apply if a demand letter was already issued for your case. We have posted a more detailed explanation in the Attorney and Insurer Toolkits.

For more information on the $300 MSPRC Threshold, Medicare Secondary Payer, or any lien resolution issue, feel free to contact Lien Settlement Solutions at info@lienss.com or by phone, (877)907-5436 extension 2. 

We are the Lawyers Solution to Lien Resolution!

THIS JUST IN: Gulf Oil Syndrome Cases Emerge

Tuesday, June 15th, 2010

Gulf Oil Spill Workers are starting to experience Adverse Health Affects due to Chemical Exposure in Oil Cleanup

As if the Gulf Oil Spill weren’t enough of a disaster, another crisis is beginning to take shape amidst the cleanup effort.  Gulf Oil Syndrome (also called Oil Spill Syndrome) is being seen in emergency rooms and mobile health units among cleanup workers, fishermen, and others who are involved in the conservation effort.  Chemicals like Benzene, Toulene, Xylene, Naphthalene, Ethylbenzene*, and others are now found in the air, primarily through the burning of oil and the use of chemicals that dissolve or dilute oil.  Exposure to light crude oil, burning oil particles, oil spill dispersants, and other chemicals can cause a host of health problems. 

Some of the milder symptoms include*: Read the rest of this entry »

This Just In… Toyota Recalls May Have Subrogation Issues

Wednesday, February 17th, 2010

As automobile maker Toyota announces new warnings and repairs for many of its models, law firms nationwide are gearing up for legal issues that have resulted from the massive recall.  Millions of cars are in the process of being repaired by Toyota in an effort to avoid any further issues with the faulty vehicles.  However, there is a growing number of firms who are investigating possible lawsuits against Toyota, especially in accident and injury cases that include one of the recalled vehicles. 

Insurers are looking through their settlements to see if subrogation is an option.  State Farm has already started evaluating possible subrogation action, stating that “could result in us subrogating against the vehicle manufacturer,” (Varro, www.insurancenetworking.com).  According to National Underwriter Online News (www.property-casualty.com) Allstate Insurance Company may also examine recent cases involving Toyota vehicles to determine whether there is a correlation.  According to Allstate spokesman Mike Siemienas: Read the rest of this entry »

MMSEA Update & News – October 2009

Wednesday, October 28th, 2009

Notes from the recent CMS Town Hall Teleconference on October 22, 2009:

We are rapidly approaching the date for live reporting to CMS for all Workers Compensation, Liability, and No Fault claims, 4/1/2010.  The registration deadline for RRE’s (insurers) was 9/30/09, but CMS has opted to leave the registering process open.  CMS has ensured the industry that those entities that were not registered prior to 10/1/09 will not be penalized, but it is expected that all RRE’s will be registered by the end of the year. 

Due to misinterpretation of the law under MMSEA plaintiff attorneys have been left overwhelmingly frustrated with the varying opinions in regard to whether or not a Liability MSA is now required under MMSEA?  By now plaintiff attorneys should be apprised that, although MMSEA Section 111 has nothing to do with Medicare Set-Asides, it does not dismiss the necessity of protecting Medicare’s interest in Liability cases.

Read the rest of this entry »

FJA Seminar – October 15, 2009 – Liability MSAs

Wednesday, October 28th, 2009

On October 15 – 16, 2009  Delta Settlement Solutions was a sponsor at the Florida Justice Association Seminar, held in Orlando, FL.   The event was a great way to meet and greet our colleagues and introduce our services.  Erica Cooper, Manager of Medicare Services and Compliance of Lien Settlement Solutions (a Delta Company) gave a comprehensive presentation regarding compliance under the MSP statute, titled “CMS Compliance Does Not Have To Be A Nightmare”.   Below, Erica gives her thoughts, observations of the event, and additional insight into Liability MSAs.

 The Florida Justice Association is a great organization.   I have had the opportunity to learn the admirable members of the FJA as well as the broad education and strong foundation it provides to our legal community.  It is a privilege to support a group such as the FJA.

Many of the participants in attendance expressed great concern when handling Liability cases and whether or not an MSA is required?  For whatever the reason the industry has made an already complex matter more difficult to implement in attorneys day to day practice.  So allow me to provide as much clarity as I can regarding this matter.

We first have to remember that MMSEA Section 111 has nothing to do with Medicare Set-Asides.  Secondly an MSA is only considered such when an allocation is submitted to CMS.  Otherwise, when an analysis of future medical costs is created it is simply an allocation. 

Protecting Medicare’s interest is relevant to all Workers Compensation, Liability, and No Fault claims.  For both past and future medical expenses paid and that can be expected to be paid.  Lack of a “formal” review process by CMS for proposed Liability MSA’s, does not dismiss the necessity of an allocation to protect Medicare’s interest for future medical expenses.  When addressing this topic there are two questions: 

1)      Do you need to allocate?

2)      Do you need to submit the allocation to CMS for review? 

Read the rest of this entry »

Are MSA’s required in Liability Cases?

Friday, September 25th, 2009

 A Medicare Insider’s Clarification on MSA Confusion

medicare maze

According to Section 111 of the MMSEA (Medicare, Medicaid &SCHIP Extension Act), primary payers are to (1) identify the Medicare eligibility status of plaintiffs and (2) report all Medicare beneficiaries to Health and Human Services when there is a settlement, judgment, or award that is taking place in Workers Compensation, Liability, and No Fault claim.  CMS has reiterated that the MMSEA provision does not change or eliminate any existing obligations for the handling of Medicare Set Asides (“MSA”).  It is crucial to understand that the Section 111 MMSEA reporting requirements are a completely separate matter from MSAs.

The misinformation that trial lawyers have received is creating great confusion with regard to what is required under the Medicare Secondary Payer Act (“MSP”) when settling future medical in a liability claim.  Is an MSA necessary or not?  Those entities that have taken the position that an MSA is “required” in liability settlements likely have financial incentives for taking that position.  The only answer regarding whether you have to set up an MSA in liability cases is that there simply are no definitive answers.  With the absence of specific statutory or regulatory language mandating that an MSA be completed in a liability claim, it is left up to the trial lawyer to interpret current law and CMS pronouncements to decide whether it is appropriate to establish an MSA.

Read the rest of this entry »