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Medicare Set-Asides and Medicare Compliance

Centers for Medicare and Medicaid Services (CMS) Maintains $750 Reporting Threshold

The SMART Act requires CMS to annually review the costs associated with the collection of Medicare conditional payments and set forth a threshold amount applicable to settlements, judgments, awards or other payments (TPOC amount) for which it would not seek recovery. The threshold amount for 2017 was $750. On November 3, 2017, CMS announced the […]

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A Defendant’s Answer to Reptile Litigation

In today’s world of litigation strategy and tactics have evolved into more than putting your evidence on at trial and making good arguments on behalf of your clients to achieve the desired outcomes.  Occasionally, lawyers may retain jury consultants to help pick a jury that may be best suited to hear a particular case, but […]

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CMS Further Revises the Requirements of the WCMSA Amended Review Process

On July 12, 2017, we issued an alert explaining the new WCMSA re-review process, which is referred to as the “Amended Review” process.  A link to that alert can be found here.  Since that alert, CMS has added another requirement to be able to take advantage of the Amended Review process, which is noted in […]

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Certain Old WCMSAs may now be Re-reviewed by CMS!

A Second Bite at the Apple? CMS Expands the WCMSA Re-Review Process Do you have cases that you cannot settle due to an outdated, CMS-approved WCMSA?  If so, there is good news – CMS has expanded its WCMSA Re-Review process, which allows for resubmission of those old CMS-approved WCMSAs in certain situations. Section 12.4 of […]

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Changes to Medicaid’s Right to Recovery from Injury Settlements is Drawing Near

As a brief background, Medicaid’s recovery rights from tortious settlements and judgments are set forth in federal and state statutes and, at times, have conflicted. In 2006, the United States Supreme Court issued a decision, Arkansas Department of Human Services v. Ahlborn, 547 U.S. 268 (2006), finding that only the portion of a settlement designated […]

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Medicare Beneficiaries Cannot Rely on Estimated Conditional Payment Amounts in Making Settlement Decisions

On March 23, 2017, a decision from the South District of Florida, Shapiro v. Secretary of HHS, 2017 U.S. Dist. LEXIS 42278, confirmed Medicare beneficiaries cannot rely on estimated conditional payment amounts from the Centers for Medicare and Medicaid Services (CMS) in making settlement decisions. The Medicare beneficiary Plaintiff, Shapiro, was injured in an automobile […]

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CMS Announces Changes Coming to the Re-Review Process of Approved WCMSAs

The Centers for Medicare & Medicaid Services (CMS) just announced it has been reviewing its process for addressing requests for CMS to “re-review” approved Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) amounts and plans to make a change in 2017.  CMS expects to update its existing re-review process to address situations where CMS has provided an […]

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Shannon Metcalf to Present at Medicare Secondary Payer Master Class Conference

North Carolina – January 20, 2016. Hedrick Gardner Kincheloe & Garofalo LLP, a leading regional law firm, is pleased to announce that attorney Shannon Metcalf has been invited to present at the upcoming Medicare Secondary Payer Master Class Conference. The event will be held January 25-26, 2016 at the Wyndham Orlando Resort International Drive in […]

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Hedrick Gardner Heads to the Hill

  On June 11, 2015, Hedrick Gardner Attorney Erin Collins, co-chair of the National Alliance of Medicare Set-Aside Professionals (NAMSAP) legislative committee and a NAMSAP member, will “Take the Hill” to meet with Senators and members of the House of Representatives and/or their staff members. The purpose of these meetings is to discuss the Medicare […]

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