Medicare Compliance

Medicare compliance is no simple task. With more people entering the Medicare system, the Centers for Medicare and Medicaid Services (CMS) has increased efforts to protect the Medicare trust funds from depletion. As Medicare Secondary Payer (MSP) compliance rules evolve, now more than ever you need an expert partner to help you navigate the Medicare process.

What is the MSP Act?

Since 1980, the MSP Act has been the primary method for recovering money to replenish Medicare trust funds. Under the act, CMS is to be a secondary payer of workers compensation, liability, and no-fault insurance claims. If an entity bills Medicare for any medical service or products provided to a Medicare beneficiary, it must determine whether Medicare is the primary payer for those items or services.

To combat increasing fraud, shrinking funding sources, and escalating healthcare costs, through federal legislation, Medicare is cracking down on noncompliance. Medicare is imposing substantial financial penalties for non-compliance and requiring responsible parties to:

  • Report claims involving Medicare to CMS
  • Set up an MSA account to pay for future Medicare covered services
  • Reimburse Medicare for conditional payments made to healthcare providers on behalf of beneficiaries

Our Medicare Compliance Services

Synergy offers Total Medicare Compliance Services to assist attorneys and their clients. Our services include:

  • Identify/Resolution of Conditional Payments & Part C lien resolution
  • Refund Process for Conditional Payments made to Medicare
  • MSA Consultation, Funding, and Administration
  • MSA Allocation Services
  • CMS Review & Approval of Set-Aside Allocations
  • No Cost Attendance at Mediation for Client Consultation & Planning Advice
  • Settlement Documentation Consultation for MSP Compliance
  • Free Audit of Law Firm Client Files for Compliance with MSP
  • Free Firm Wide MSP Compliance Training

Why Synergy?

At Synergy Settlement Solutions, we provide our clients with a comprehensive set of services to ensure you and your clients achieve medicare compliance. We will estimate your client’s future Medicare covered services and submit the allocation to CMS for approval. We will also provide funding options, post-settlement planning recommendations, and professional administration. Whatever your client needs are regarding MSA and MSP, we are an invaluable solution for your post-settlement needs.

For more information or to schedule a consultation, please submit our contact request form or call (877) 242-0022.

Disclaimer: The information contained in this article is for general educational information only. This information does not constitute legal advice, is not intended to constitute legal advice, nor should it be relied upon as legal advice for your specific factual pattern or situation.

TESTIMONIALS

"Coincidentally, on the day of a recent Synergy Seminar on Medicare & ERISA lien resolution I received a letter on an ERISA lien. This letter followed much back and forth between myself and the recovery vendor for BCBS. Despite my efforts they were adamant there would be no (zero)(zilch)(nada) reduction and provided case law to support their position. I tried Synergy’s Lien Resolution Services since I had just heard their Director of Lien Resolution speak. Synergy got them to reduce their claim by a third in less than ten (10) days. The result was quick and the fee very reasonable. If you have a tough ERISA lien and your typical efforts don’t work, give Synergy a try."

Michael S. Smith, Esq.
Lesser, Lesser, Landy & Smith, PLLC

Synergy’s team makes it easy to deal with all of the issues we hate at the end of the case. Dealing with Medicare, ERISA liens, keeping eligibility intact for Medicaid and complicated planning for the client’s recovery. The experts we work with regularly at Synergy do a great job of making sure I am protected as are my clients.

J. Clancey Bounds
Bounds Law Group

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