The Section 111 Penalty Era Has Started. It Is a Plaintiff Problem, Not an Insurer Problem.
Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 requires liability insurers, no-fault insurers, workers’ compensation carriers, and self-insured entities to report settlements, judgments, and awards involving Medicare beneficiaries to CMS. The reporting captures the beneficiary’s identity, …
How to Build Medicare Compliance in a PI Firm
Medicare compliance sits at the center of modern personal injury practice operations. Trial lawyers and paralegals face real exposure when Medicare interests go unaddressed or get handled incorrectly. The risk is not abstract. Medicare can assert direct recovery rights, including
Post Final Demand Medicare Compromise & Waiver: Better Client Outcomes
When a Medicare final demand hits, the timer starts. Payment is due within 60 days or interest begins to accrue. If you miss that window, the debt can end up with the U.S. Treasury. But for personal injury firms, the
The Real Cost of MSP Mistakes
Why Medicare Compliance Can’t Be Ignored
If you represent injury victims who are Medicare eligible, strict Medicare Secondary Payer Act (MSPA) compliance is not an option. The risks are real, and the consequences can be serious. Missteps don’t only harm
Understanding Medicare Compliance in Personal Injury Settlements
If your client is on Medicare, Medicare compliance must be part of your resolution strategy. Failing to address the Medicare Secondary Payer Act (MSP) can trigger denials of future care, government recovery actions, or worse, personal liability for your law
Why Medicare Conditional Payments and Advantage Plan Liens Matter More Than Ever
If your firm is settling personal injury cases, Medicare conditional payments and Medicare Advantage Plan (MAO) liens aren’t just red tape, they’re legal minefields. Overlooking them could cost your client and your firm big.
Here’s what you need to know
AI, Medicare, and the Rising Stakes in Personal Injury Settlements
If you represent Medicare beneficiaries, the message from Washington is clear: compliance is no longer optional—and CMS is now enlisting artificial intelligence to enforce it.
In June 2025, the Medicare Trustees sounded the alarm: the Medicare Hospital Insurance (HI) Trust
Complying with the Medicare Secondary Payer Act When a Client has Public Benefits
August 11, 2022
Evelynn Passino, J.D.
For clients with public benefits, closing out their case is not as simple as issuing a check for their net recovery. If the client has Medicare or will be eligible soon, then steps must …
Exploring Options for Conditional Payment Resolution
July 8, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
Most attorneys are well aware of the need to resolve Medicare’s conditional payments in connection with a client’s settlement. This obligation stems from the Medicare Secondary Payer (MSP) Act, 42 U.S.C. § …
Post-Settlement Conditional Payment Issues in Workers’ Compensation Claims
May 13, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
The conditional payment recovery process in a workers’ compensation claim is not always smooth. Although the workers’ compensation insurance carrier will generally resolve any conditional payments in an accepted claim, the injured …
