This month our attorney spotlight features Jen Baker. Many of you have likely had the opportunity to work with Jen. She has been handling Medicare Secondary Payer issues at Carr Allison for over ten years. She lives in Jacksonville, Florida with her husband, two daughters, and their lab. Here are a few fun facts that will help you get to know her better. What is your favorite travel destination, and why? Maine! We go every summer to visit family. The weather is perfect,
The Medicare Secondary Payer Act is known for being among the most complex statutes written. One Court described it as one of the most “impenetrable texts within human experience.” Ass’n of Va. V. Kozlowski, 42 F.3d 1444, 1450 (4th Cir. 1994). Given the complex nature of the statute and the challenges it poses to settlement, one of our primary goals is to educate our clients and colleagues and provide the tools needed to settle claims and comply with the MSPA. With that goa
The United States District Court for the Southern District of Florida has issued more decisions in a line of cases filed by an entity seeking to recover conditional payment claims made by Medicare Advantage Organizations (MAO). MSP Recovery Claims v. United Auto Ins. Co., 20-20887-CIV-ALTONAGA, 2021 U.S. Dist. LEXIS 37013 (S.D. Fla. Feb. 4, 2021); MSP Recovery Claims v. Endurance Am. Ins. Co., 20-23219-Civ-Scola, 2021 U.S. Dist. LEXIS 32865 (S.D. Fla. Feb. 23, 2021); and MSP
In Sims v. Pma Ins. Co., 2021 U.S. Dist. LEXIS 20434, the US District Court for the Middle District of North Carolina dismissed the Plaintiff’s claim seeking recovery for the alleged failure of the Defendant, PMA Insurance Company, to reimburse Medicare for conditional payments related to her workers’ compensation claim. In 2011, the Plaintiff was injured at work. Following an initial denial of the claim, in 2012 the Defendant accepted the claimed injury, including future me
Beginning March 27, 2021, CMS will start using the CDC’s “Table 1: Life Table for the total population: United States, 2018” for Workers’ Compensation Medicare Set Aside life expectancy calculations. The 2018 table may be found at: https://www.cdc.gov/nchs/data/nvsr/nvsr69/nvsr69-12-508.pdf.
Bringing It All Together: The Moving Components of Medicare Secondary Payer Compliance During this webinar, attendees will have the unique opportunity to hear some of the country’s leading experts come together to discuss important Medicare Secondary Payer issues. Topics will include effective strategies for resolving workers' compensation and liability cases while complying with the Medicare Secondary Payer Act including pharmaceutical reviews, structured settlements and pr
The U.S. District Court for the Southern District of Florida recently considered the interplay between the Medicare Secondary Payer Act and Florida’s medical malpractice collateral source statute. Gordon v. Azar, 2021 U.S. Dist. LEXIS 28314, (S. D. Fla. 2021). There, the Plaintiff settled his medical malpractice claim for $1,000,000 and subsequently received a demand for reimbursement of conditional payments from CMS for $75,701.81. The Plaintiff appealed these claims and w