Synergy Blog

CMS Gearing Up to Reject Medicare Claims Related to Liability Settlements: LMSAs on the Horizon

By B. Josh Pettingill Last week, the Centers for Medicare and Medicaid Services (CMS) released a “CMS Manual System” “One-Time Notification” regarding Liability Medicare Set Asides and enforcement of the Medicare Secondary Payer statute (MSP). Starting October 1, 2017, Medicare and their contractors will reject medical claims submitted post-resolution of a liability settlement on the…

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Supreme Court Rejects Change in Lien Res. Outsourcing

After nearly five years, on October 6, 2016, the Florida Supreme Court issued Opinion SC16-104 and declined to make any change to the existing Rules Regulating the Florida Bar in relation to lien resolution outsourcing. As Florida’s trial attorneys know, the issue of whether there was a need for a change in the existing rules…

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Medicare Reduces Reporting Threshold from $1,000 to $750

Medicare has reduced the threshold for when a physical trauma-based liability settlement is large enough that the beneficiary needs to report it and repay conditional payments. On November 15, 2016, the Centers for Medicare & Medicaid Services (“CMS”) issued an alert which decreased the current reporting threshold from $1,000 to $750. The threshold decrease is…

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A Day in the Life

By Anthony F. Prieto, Jr., CFP® I consider myself to be a very fortunate person. I have a supportive family and friends. I have a job that allows me to meet, and more importantly help, great people who are in need on a daily basis. I was recently asked what is Synergy and what do…

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Damages “shall” be in an amount double… Medicare Advantage Plans

By David L. Place, J.D. On Monday, August 8th, the 11th Circuit affirmed the decision of the Southern District of Florida to award a Humana Medicare Advantage plan double damages when they were not repaid at the conclusion of a personal injury action. In Humana Medical Plan, Inc. v. Western Heritage Ins. Co., No. 15-11436 (11th…

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The Alphabet Soup of Public Benefits

By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC Attorneys and clients alike get very confused about which governmental benefits are involved in a case as a result of the accident related disability.  The acronyms for the programs are similar and governed by the same or similar government agencies.  For example, a disabled client might get…

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CMS Announces Consideration for Expansion of Liability MSAs

CMS Announcement June 8, 2016 – Consideration for Expansion of Medicare Set-Aside Arrangements (MSA) “The Centers for Medicare and Medicaid Services (CMS) is considering expanding its voluntary Medicare Set-Aside Arrangements (MSA) amount review process to include the review of proposed liability insurance (including self-insurance) and no-fault insurance MSA amounts. CMS plans to work closely with…

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A Primer on Medicare Set Aside Self-Administration

Synergy receives numerous calls every week regarding what is required to properly self-administer an MSA.  The purpose of this article is to provide some guidance to attorneys regarding self-administered Medicare set aside (MSA) accounts. In administering MSAs, funds may only be used to pay for future Medicare covered, injury related medical expenses of the plaintiff.

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Anti-Subrogation Beats FEHBA

On May 3, 2016 the Supreme Court of Missouri, sitting en banc, once again sided with the injury victim, and reason. Upon remand from the United States Supreme Court, the Supreme Court of Missouri refused to give Chevron deference to the recent self-serving rule change by the Office of Personnel Management (OPM) (referring to Chevron…

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5 Ways Lawyers Can Maximize Their Wealth By Deferring Fees

Leif Lundberg, LL.M and Ben Eisler, JurisPrudent Deferral Solutions Takeaways Defer compensation like Fortune 500 executives do, so your money grows faster. Tie your fee to the returns of investments that you select – stocks, bonds, real estate, etc. Gain access to low-interest loans, as needed, to fund cases (currently 3-4%). Use “golden handcuffs” to…

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