AAJ Response to the U.S. Supreme Court’s decision on the Affordable Care Act

Washington, DC—The following is a statement from the American Association for Justice (AAJ) President Gary M. Paul in response to the U.S. Supreme Court’s decision on the constitutionality of the Affordable Care Act:

“Today’s Supreme Court ruling is a step forward not only in the fight to expand access to healthcare, but also in the fight to protect patients’ access to justice.

“This ruling bolsters AAJ’s longstanding argument that federal efforts to deny patients’ legal rights by mandating changes to state laws and state courts exceed Congress’s authority under the Commerce Clause and violate our system of federalism.

“Going forward, any efforts to address the American healthcare system must have a strong focus on improving patient safety and ensuring accountability.”

--- As the world's largest trial bar, the American Association for Justice (formerly known as the Association of Trial Lawyers of America) works to make sure people have a fair chance to receive justice through the legal system when they are injured by the negligence or misconduct of others—even when it means taking on the most powerful corporations.
Visit http://www.justice.org/newsroom.

CMS Seeks Public Comments on Liability MSA's

June 15th, 2012

Douglas L. Shaw, C.P.A., C.M.A,CMSP
Chief Operating Officer

An Advanced Notice of Public Rule making (ANPRM), CMS-6047-ANPRM, from the Centers for Medicare and Medicaid Services (CMS) was published in the July 15, 2012 Federal Register.  This notice is likely a response by CMS to numerous requests for guidance that clarifies how to resolve obligations regarding "future medicals" in liability settlements under the Medicare Secondary Payer(MSP) statute.

Since 2001, CMS has a recommended a formal, yet voluntary, Medicare set-aside (MSA) arrangement for workers' compensation settlements to satisfy obligations under the MSP statute.   According to a recent Government Accountability Office report, the MSA program saved the Medicare Trust Fund approximately $1.1B in 2011.

CMS is now soliciting public comment on whether and how Medicare should implement a similar process for liability insurance settlements.  In addition, CMS is requesting comment on some proposed definitions and outlined options.   Their goal is to "ensure that the process related to 'future medicals' is understandable, efficient, and reflects industry practice, while protecting Medicare beneficiaries and the Medicare Trust Funds."

Medicare is considering seven options for addressing "future medicals".  Options 1-4 would be available to Medicare beneficiaries and those who are not yet beneficiaries.  Options 5-7 would be available to beneficiaries only.

1.    The beneficiary pays for future medicals out of the settlement funds, until exhausted, with random CMS audits.

2.    Medicare would not pursue future medicals if certain conditions are met including relating to the amount of the settlement, the type of injury, the injured persons Medicare status, etc.

3.    The injured person provides an attestation regarding the Date of Care Completion from his/her treating physician.

4.    The individual/beneficiary submits a Liability MSA for CMS' review and approval.

5.    The beneficiary participates in one of the three new Medicare recovery options regarding a $300 threshold, a fixed payment option or $25,000 or less self-payment option.

6.    The beneficiary makes an upfront payment to Medicare.

7.    The beneficiary obtains a compromise or waiver of recovery and Medicare would have the discretion to not pursue future medicals.

CMS  is requesting comment on the feasibility of all of these options, as well as any additional options.  Comments must be received within 60 days. It is anticipated that the next step, after reviewing comments from this ANPRM, will be for CMS to publish proposed regulations, which will prompt another public comment before becoming final.  A flood of comments from a host of interested parties is expected.

For more information, please visit www.medivest.com!

"How Advertising - Not Just by Lawyers - And the Media Impact the Way Jurors See You & Your Client"

Please Join VCTLA for a Dinner Program on June 26, 2012 at the Courtyard Marriott in Oxnard, and earn 1 MCLE Credit.

Reception 6 pm and Dinner 6:30 pm.

Andrew Fraser brings his well received East Coast presentation on lawyer advertising to Ventura.

Honored as a 2012 "Top 100" New Jersey Trial Lawyer by the National Trial Lawyers Assoc., Andrew will educate and entertain as he shows what you have overlooked in the media, and how the public sees trial lawyers and their clients. Humorous yet revealing, this fast paced one hour program is a must see. Please join us. All are welcome.

Click here for the flyer. RSVP today!