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New Mexico Federal District Court Finds CMS’ Failure to Clarify if MSAs are Required in Liability Settlements Proving Burdensome in Settlement Process

On November 28, 2017, the United States District Court for the District of New Mexico published its opinion in Silva v. Burwell, concluding that the uncertainty created by CMS’s repeated failure to clarify its position on requiring MSAs in personal injury settlements generally and in specific cases is proving burdensome to the settlement process. The Court further finds this case is not ripe for review because no federal law mandates CMS to decide whether Plaintiff is required to create a MSA. The Court reiterates that just because CMS has not responded to Plaintiff’s requests to clarify whether an MSA is required in personal injury claims is not reason enough for this Court to step in and determine the propriety of its actions. There may be a day when CMS requires the creation of MSA’s in personal injury cases, but that day has not arrived.

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Illinois Federal District Court Finds Surviving Spouse and Adult Children Must Reimburse Medicare $105,000 from Med Mal $250,000 Settlement

illinois Federal Disctrict Court Find Surviving Spouse and Adult Children Must Reimburse Medicare

On November 26, 2017, the United States District Court for the Northern District of Illinois published its opinion on Paraskevas v. Price, concluding that Medicare did not abuse its discretion in finding that the state court settlement order was not on the merits and was therefore not binding on CMS when seeking reimbursement of conditional payments. The Court finds the settlement compensated Plaintiff not only for the wrongful death action, but also the estate’s survivor claims in connection with the medical malpractice claim. Medicare’s decision is affirmed, and the Secretary’s final decision that Plaintiff owes $105,000 plus interest in reimbursement of conditional payments made stands.

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Conditional Payment Compliance Risks for Auto, Liability, No-Fault, and Work Comp Primary Payers

With Medicare still in financial short and long term trouble, the US Department of Health and Human Services (HHS), and its Center for Medicare and Medicaid Services (CMS), have become increasingly more aggressive about making sure Medicare is the secondary payer pre and post settlement in auto, liability, no-fault, and workers compensation claims. As a result, insurers, self insureds, and third party administrators responsible for payment of auto, liability, no-fault, and work comp claims must be aware of and understand their responsibilities under the Medicare Secondary Payer Act (MSP), and be prepared for the multiple risks associated with MSP compliance. What follows is part two of a four-part analysis of risks associated with each of the MSP compliance components: Mandatory Insurer Reporting (MIR), Conditional Payment Resolution (CPR), and Medicare Set Asides (MSA). This second part focuses on CPR compliance risks for auto, liability, no-fault, and work comp primary payers.

 

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Ease Your Way In To The Global Stock Market

Heads up, you know darned well that you have to do something with your money. Something besides enjoying your weekends and getting your hands on the latest electronic gadget. That something, as you have probably already figured out is about getting up close and personal with the world of investments.

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True or False? — It Takes Money to Make Money

The short answer is YES; of course it takes money to make money. To make money in the stock market, you must have money to make the initial stock purchases. Starting a business requires money to buy inventory, marketing materials, office space and equipment. Even lottery winners have had to have the seed money.

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Wealth Building Tips for Modern Day Millennials

Millennial! Another of those media driven buzzwords, used to label those between the ages of 18 and 34, while the term Gen Xers define those between 35 and 50 years of age. Boomers, the group to which I belong, are those 51 through 69. This post covers 8 key pieces of advice.

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Gina Cox No Comments

Uncommon Wealth Building Wisdom – The Benchmark

There is a common trait that shows up on the road to building your wealth. This trait shows up as you continue to add to your investment portfolio. You do have an investment portfolio don’t you? And don’t even start the blame game when this trait is revealed in just a moment.

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Top Budget Hacks for Planning and Accounting

Something most rags-to riches stories have in common is that a good budget is always needed to help anyone achieve financial security. If you want to significantly improve your credit, you have to learn how to pace your spending and increase your savings.

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Tips for Avoiding an Out of Money Experience

Do you run out of money before you run out of month? Many do, but it doesn’t have to be that way! Wealth is the result of widening the gap between what you earn and what you spend. Most of us make the mistake of ramping up our spending as our disposable incomes rise. This is self-defeating. If you do not develop a respect for money, it will always elude you.

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