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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!

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New MSPRC Alert Regarding Suspension of Final Demand and RAR Letters

Wednesday, May 25th, 2011

This Just In:

The Medicare Secondary Payer Recovery Contractor has issued an alert on their website, www.msprc.info, notifying of a temprorary suspension of the issuance if Final Demand and Rights and Responsibilities letters. 

“News and Updates

Alert: Issuance of the Rights and Responsibilities (RAR) and Demand letters has been temporarily suspended

Issuance of the Rights and Responsibilities (“RAR”) and Demand letters has been temporarily suspended while these letters are under review. The MSPRC is still working cases, and the RAR and Demand letters will be mailed out once appropriate revisions have been made. ” From www.msprc.info.

Jason D. Lazarus, Esq, CEO of Synergy Settlement Services has written a complete explanation on the MSPRC suspensions, and the recent  Haro v. Sebelius decision in Arizona.  CLICK HERE to learn more about this matter.

Lien Settlement Solutions will continue to provide updates as soon as new information is received regarding this and any other Medicare Resolution issue.  For more information on how Lien Settlement Solutions can assist your firm, please contact us at info@lienss.com, or by calling (877)907-5436.

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A Timeline for Medicare Lien Resolution with MSPRC

Tuesday, November 2nd, 2010

MSPRC Resolution Timeline*

CMS has revamped the Medicare recovery process, creating a more efficient and less questionable path for the verification of Medicare conditional payments.  Based on a compilation of facts from www.MSPRC.info,  Medicare Correspondence, and daily interaction with MSPRC,  we have created a timeline to a serve as a general guide to the Medicare Resolution Process,  and what can be expected by all parties entering a settlement with a possible Medicare obligation. 

 The following is an approximate timeline for the Medicare recovery process*:

  1. Day 1:  Report to Coordination of Benefits Contractor (COBC) by calling 1(800)999-1118.
  2. Day 2 – 12:  The case is transferred to the Medicare Secondary Payer Contractor (MSPRC) from the COBC within 2 weeks. Read the rest of this entry »

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CMS Update- MMSEA Section 111

Monday, October 4th, 2010

CMS has made the following updates to the MMSEA section of the CMS website: http://www.cms.gov/mandatoryinsrep/04_whats_new.asp:

September 30, 2010

  • Posted the September 22, 2010 NGHP Town Hall Teleconference Transcript to the NGHP Transcripts section page.
  • Moved the January 28, 2010 NGHP Town Hall Teleconference Transcript to the Mandatory Insurer Reporting section page under NGHP Transcripts.
  • Moved the May 26, 2009 Alert: Compliance Guidance Regarding Obtaining Individual HICNs and/or SSNs for Group Health Plan from the What’s New section page to the GHP Alerts section page.
  • Moved the August 24, 2009 – HICN, SSN Collection – NGHP Model Language from the What’s New section page to the NGHP section page. Read the rest of this entry »

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Florida Bar Lien Resolution Outsourcing Proposed Rule Released

Monday, June 28th, 2010

There has been some concern and questions regarding the outsourcing of lien resolution and the ability to pass along those costs to the client.  There were also questions regarding cases where another lawyer handles a lien resolution issue on a reverse contingency and how fees could be charged.  The bar formed a committee to look at these issues after an ethics opinion request.  The committee has issued a new proposed rule (below) that would allow for a lawyer to outsource if it is disclosed in the initial fee contract.  The costs come out of the client’s recovery, not the lawyer’s contingent fee.  The new rule is not final until approved by the Florida Supreme Court and may be tweaked by the bar through its internal review process in between now and when the Supreme Court reviews it.  However, it provides guidance. Read the rest of this entry »

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Ask a Lien Professional: Can the VA Recover from UM Coverage?

Thursday, June 3rd, 2010

Question: 

Do the VA subrogation rights apply to UM coverage, or do they only apply to the responsible third-party?

Answer: 

The right of the VA to recovery from UM is not a definite yes or no answer.       

When the VA cannot recover:

In researching UM recovery in VA cases, we have to look to the language within the UM plan.  According to Government Employees Insurance Co. v. Andujar, 773 F.Supp. 282, it was determined that the ability of the US Read the rest of this entry »

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Ask A Lien Professional – Wrongful Death and Medicare

Wednesday, May 5th, 2010

Question: 

“I am the executor of estate on behalf of my mother who was a Medicare beneficiary.  This is a wrongful death case, so does Medicare have a lien in this situation?“  – Florida Resident

Answer:

According to the Medicare Secondary Payer Manual (Chapter 50.5.4.1.1), Medicare’s right to recover against a wrongful death claim depends on two things, 1. The beneficiary’s state of residence, and if the state law allows for the recovery of medical expenses in a wrongful death claim, and 2. If the state’s law allows for recovery of medical claims, the amount Medicare is entitled to recover against may vary (full recovery in some states, limited recovery in others).  So basically, depending on where the beneficiary lived, there may or may not be an obligation to Medicare.  Some states do not allow for the recovery of medical payments, so in those states Medicare cannot assert a claim against the deceased beneficiary or survivors.  Read the rest of this entry »

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Ask a Lien Professional – ERISA Subrogation & Reform

Wednesday, March 31st, 2010

QUESTION: 

Will the new Health Care Reform Law have any affect on ERISA plans and subrogation in the future? – FL Attorney 

ANSWER:

Right now there are many unknown variables regarding ERISA plans and the new Patient Protection and Affordable Care Act of 2010 that was signed into law on March 23, 2010.  What we do know is that health insurance practices, including Subrogation and Recovery will experience changes over the next few years. 

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for most voluntarily established pension and health plans in private industry to provide protection for individuals in these plans (US Department of Labor, www.dol.gov).  Employer provided health plans are governed by ERISA, which also loosely defines their right of recovery, allowing for “appropriate equitable relief” (29 USC 1132(a)(3)).  Plans that are Read the rest of this entry »

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LSS Project and Multi-Case Resolution Program

Tuesday, March 30th, 2010

Lien Settlement Solutions is now equipped to handle Multiple Claimant Projects! 

In settlements like Asbestos Exposure/Mesothelioma diagnoses, Pharmaceutical Liability, Environmental Exposure, or Single Incident Personal Injury cases (among others), LSS can assist with the case management and compliance of files that may have an obligation to an insurer or provider.  We are able to create a resolution package for projects ranging from 5 – 1,000+individual claimants or beneficiaries.  From pre-screening, intake, reporting and resolution we have developed a process that will save your firm the time and headache of resolving multiple claims with several different potential lien holders. 

Our Project Resolution Program includes:

  • Pre-Screening – Before cases are submitted for resolution, we will review all related exposure, benefit eligibility, and billing records to verify the need for resolution services in an individual case.  For cases submitted for Asbestos Lien Resolution services, we will determine if the case meets Medicare’s provision for recovery of cases with exposure on or after December 5, 1980. Read the rest of this entry »

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Changes in the MSPRC Conditional Payment Process- Webinar 04/14/2010

Friday, March 26th, 2010
The following Webinar is being provided by the MSPRC regarding the conditional payment and demand process.  The following information has been provided by the MSPRC:

Reserve your Webinar seat now at:
https://www1.gotomeeting.com/register/343904584
 
New changes have been made to the MSPRC Conditional Payment and Demand Process. This Town Hall Meeting will provide education on the New Conditional Payment Notice and Process, as well as updates on:-The MSPRC Recovery Process & Timelines-The Rights and Responsibilities Letter-Proof of Representation vs. Consent to Release-What’s new with the MSPRC      
 
Title:   Changes in the MSPRC Conditional Payment Process for Liability Insurance, No-Fault Insurance, and Workers’ Compensation Cases 
     
Date:   Wednesday, April 14, 2010
     
Time:   1:00 PM – 3:00 PM EDT
 
After registering you will receive a confirmation email containing information about joining the Webinar.

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