Robert P. Horton, Esq. | Attorney, Kisling Nestico & Reddick Our firm has been utilizing Providio's free case consultation service for several years when we have liability cases that we are settling for Medicare-eligible clients. The uncertainty and lack of guidance around how to comply with the future medicals aspect of the Medicare Secondary Payer act is troubling for any good attorney who wants to ensure his/her client is protected and that s/he is following the law. By working with Providio's MSP compliance experts to discuss the specific facts of a case, we feel we're doing everything we can to protect our clients and make informed decisions with them in light of the most up-to-date law and guidance available. Providio's team is highly responsive, knowledgeable and friendly...we will undoubtedly continue to use their services and wouldn't hesitate to recommend them to others.
Medicare Secondary Payer Compliance (or “MSP Compliance”) is far from simple. While we have well-defined directions from CMS regarding compliance in workers' compensation cases and some broad advice to follow in liability cases; questions still abound on all sides. That's why MSP Compliance support from Providio is important.
Questions arise because the Medicare Secondary Payer Statute (42 USC § 1395y(b)) and accompanying administrative guidance do not set clear guidelines on how to ensure that Medicare is a secondary payer in all situations. In order to help various stakeholders in both workers' compensation and liability cases, Providio offers MSP Compliance services to help simplify and streamline an otherwise complex process:
- Free Case Consultations
- Medicare Conditional Payment Services
- Guidance on Treating Physician Letters for Liability Cases (09/29/2011 CMS Guidance Memorandum)
- Guidance on No-Action or No-MSA Memorandums
- Medicare and Settlement Guidebook
- Medicare Set Asides (MSAs) and Related Services for Workers' Compensation and Liability Cases
Our Consultation Process
With Providio's free, no-obligation case consultations, attorneys, paralegals and claims adjusters now have an easy opportunity to discuss the facts of their specific cases with professional MSP compliance specialists — all with no obligation. Upon discussing the facts of your specific case, the experts at Providio will review, analyze and discuss the overall situation with you. They will then apply the most up-to-date case law and emerging administrative guidance in order to make the best recommendations to you.
Providio's proprietary Medicare and Settlement Guidebook provides vitally important educational information about the Medicare beneficiary's responsibilities to Medicare for all future medical costs associated with the injury that was the original subject of their case settlement. This book also includes information that will assist those claimants who elect to self-administer their own MSAs and provides them with access to both our online compliance tool and toll-free customer support.
Uses for the Guidebook
The Guidebook — along with its accompanying online compliance tool — is useful in two primary situations. The first is when the Guidebook is combined with a Medicare set-aside (MSA) for those clients who may elect to self-administer their MSAs. The second is when the Guidebook is used in lieu of an MSA. This may occur in certain liability settlements where an MSA may not be warranted, yet all parties involved want to ensure that Medicare's interests are protected and taken into account.