HOW MUCH MUST BE SET ASIDE FOR MEDICARE IN A THIRD PARTY LIABILITY CASE?
by Thomas D. Begley, Jr., CELA Once a Medicare Set-Aside Arrangement (“MSA”) has been considered, the next question is how much is necessary to fund it. If future medicals have been plead or claimed and future medicals are specifically released in a Release signed in connection with the third party liability (“TPL”) settlement, then it…
DO WE STILL NEED TO WORRY ABOUT MEDICARE SET-ASIDE ARRANGEMENTS?
by Thomas D. Begley, Jr., CELA For many years a debate has raged as to whether Medicare’s interests must be considered with respect to future medical payments in the context of a third party liability settlement (“TPLS”). The issue is simple. If a plaintiff in a TPLS receives money to pay for future medical care,…
RESOLVING FEDERAL EMPLOYEE HEALTH BENEFIT ACT AND FEDERAL MEDICAL CARE RECOVERY ACT LIENS IN PERSONAL INJURY CASES
by Thomas D. Begley, Jr., CELA Federal Employee Health Benefit Act The Federal Employee Health Benefit Act (FEHBA) provides group health insurance for federal employees.[1] Although there is no statutory right of subrogation or reimbursement, FEHBA contains a preemption provision under which the terms of insurance contracts issued by its private carriers purportedly preempts…
MEDICARE SET-ASIDE ARRANGEMENTS IN SPECIAL NEEDS TRUSTS
by Thomas D. Begley, Jr., CELA Countable Asset for SSI and Medicaid A question arises as to whether assets held in an MSA are countable for SSI and Medicaid purposes. This has been addressed by CMS in the WC context, but the same line of reasoning should apply to third party liability cases. CMS…
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