Medicare is a secondary payer when a primary payer is available and has a demonstrated responsibility to make payment.

Medicare exposure can be significantly impacted by claim decisions made early in the handling of a workers’ compensation case.

This Ask Amy topic comes from one of my workers’ compensation cases.

The act of manually turning a key or using a screwdriver does not require an incredible amount of force.

The Centers for Medicare and Medicaid Services (CMS) made two welcome announcements today that impact the Medicare Secondary Payer compliance community.

Pregabalin, the generic for Lyrica, became available in July of 2019.

A few months ago, we submitted an MSA in a case where Lyrica was being prescribed “off-label” for a diagnosis of lumbar radiculopathy.  CMS included it in the MSA.  The inclusion of Lyrica inflated the MSA astronomically, and nearly prevented the case from settling.  I received this question:  “How can the rules just change like this?  Isn’t there some sort of advance notice required for changes like this?  This just isn’t right!”

On April 1, 2019, the Medicare Secondary Payer Recovery Portal (MSPRP) was updated with a new feature, offering primary payers to also pay conditional payment debts electronically.

Projecting for Workers’ Compensation Medicare Set‐Asides (MSA) in order to prevent a cost shift burden to Medicare has been an evolutionary process since it began.

As the new Congress settles in and the presidential campaigns heat up, there is renewed talk of “Medicare for All.”