Gould & Lamb provides its clients with Medicare Compliance Services and Programs focused on reducing claim costs and positioning claims for settlement. To this end, Gould & Lamb has prepared a Settlement Language Guide to assist insurers and self insured entities navigate the complex sea of Medicare Secondary Payer compliance. The guide contains language for possible claims settlement scenarios with a description and analysis of possible actions. Once the Conditional Payment or Medicare Set Aside issue has been brought to light, Gould & Lamb will assist with recommending MSP appropriate and protective settlement language. If you have already produced settlement documentation that contains such language, Gould & Lamb will review same and make recommendations on any needed changes, additions, or deletions. Gould & Lamb also offers our clients detailed and specific to the claim analysis of all Medicare Secondary Payer exposure issues that may exist in your case. Gould & Lamb’s extensive and experienced MSP legal team will provide a written analysis, including statutory, regulatory, and case law citations, that outlines any Medicare Secondary Payer exposure and recommends solutions to any discovered potential problems or issues. Gould & Lamb also provides expert advice on MSP issues, available to provide expert testimony on any MSP issue at meetings, mediations, depositions, hearings, trials, or any other event our client deems our expert analysis helpful or necessary.
Video: Louisiana SMP (Senior Medicare Patrol) revised
The Official Medicare Set Aside Blog And Information Resource: Louisiana Singlehandedly Saving Medicare One Longshore Settlement at a Time
If in fact the MSA would have been acceptable to CMS, as testified to by the expert and referenced in #5 of the conclusions of law, why have we involved the resources of the federal court system to improve Medicare’s long term viability by $6,701? The parties should have simply obtained the MSA and memorialized their understanding and agreement in the settlement documents. And if CMS approval was so important, I am still not convinced that, if painted properly, CMS would have seen it as a LHWCA case anyway and conducted its review. Regardless, let us for a moment consider the expense of all parties involved in obtaining this “definitive judgment” to backstop future CMS exposure. Besides the court’s expenses, there were six attorneys of record listed all billing at an hourly rate and all the associated expenses of expert testimony. It is likely that more was spent on proving that the $6,701 MSA was adequate than was actually used to fund the MSA. And for what? To possibly limit CMS some unknown day in the future to $6,701 in excluded, related, Medicare covered services if claimant ever requires treatment to the same vertebrae again that is not caused by some intervening act.
Jindal Administration Decisions are Jeopardizing Access to Health Care
The harm resulting from cuts being implemented behind closed doors by the Jindal administration will not be limited to patients and their families. These cuts will cost thousands of Louisiana citizens their jobs, will cripple community institutions and services, endanger public safety, disrupt medical education, and threaten the viability of community hospitals, as well as dismantle the LSU Hospital system. We need to stand up and force more transparency into the decision-making process about the Medicaid program and access to health and behavioral health care across this state.
Patient Recruiter Sentenced to 18 Months in Prison for Medicare Fraud
The case was filed and prosecuted through the joint efforts of the U.S. Department of Justice, Criminal Division and the Department of Health and Human Services and more specifically, the Medicare Fraud Strike Force. The Strike Force teams federal, state, and local investigators from various agencies together to combat Medicare Fraud. It was expanded to nine locations, encompassing the Baton Rouge, Louisiana unit that prosecuted this case. According to the DOJ, the Force has charged 1,330 defendants who have falsely billed Medicare for more than four billion dollars.
Agency: Medicare refills strong drugs despite law
The Centers for Medicare and Medicaid Services said in response to the report that the inspector general was misinterpreting partial “fills” dispensed to patients in long-term care facilities as refills. Partial fills occur when a pharmacist does not dispense all doses of the prescribed medication at one time. But the report said there was little evidence of that.
KS: Rising obesity weighs on public health
The recent obesity study released by the Robert Wood Johnson Foundation, “F as in Fat,” ranked Kansas 13th overall with an obesity rate of 29.6 percent, tied with Ohio, and just behind Missouri. The ranking is three slots higher than last year when Kansas came in at 16th, with a 29 percent obesity rate. Kansas was only 18th for obesity in 2009.
There are Several Ways to Apply for Medicaid in Louisiana
It is very easy to find the eligibility requirements for Medicaid in Louisiana. They are right on the main website! To qualify, you must already be receiving Supplemental Security Income (SSI) from the Social Security Administration (SSA). You can also qualify if you currently are getting financial help from the Office of Family Support (OFS) or through the Family Independence Temporary Assistance Program (FITAP).