Matthew T. Austin

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All articles by Matthew T. Austin

 

Settlement with the U.S. Department of Justice on outstanding conditional Medicare payments is a stark reminder to look before you leap when settling a claim.

On June 18, 2018, the United States Department of Justice (DOJ) issued a press release regarding a settlement involving claims that a personal injury law firm failed to properly reimburse conditional medical payments to Medicare. This press release is a stern warning that Medicare is required, by statute, to seek reimbursement for conditional payments made as a secondary payer — and it will. See 42 U.S.C. Section 1395y (6). Conditional
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Is Failure to Provide Written Notice to an Employer Still a Viable Defense? Of Course it Is!

One of the more seemingly futile defenses to a workers’ compensation claim is the defense originating from Section 18 of the Workers’ Compensation Law requiring a claimant to provide written notice to the employer within 30 days of an incident. The statute itself provides that late notice can be excused, provided the employer had actual notice or if the employer did not suffer any prejudice for the late notice. In
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Chemical Exposure Case!? Fear Not! You Are Not at the Mercy of the Claimant’s Physician

Imagine receiving a medical report from an oncologist that notes “myelodysplastic changes to chromosome 3 and chromosome 7.” Imagine further that you see such language as “cytogenetics” that reports “abnormal results,” or that both “monosomy 7 and fusion RPM 1/MECOM typically correlate with myelodysplastic syndrome and acute myeloid leukemia.” Imagine further that this medical report is attached to a C-3 opening a claim for a causally-related occupationally acquired cancerous condition.
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The Center for Medicare & Medicaid Services Learns about Due Process: Amended Review of Approved Medicare Set-Asides and What it Means for Defense Bar

Recently, the Center for Medicare & Medicaid Services (CMS) promulgated a revised Medicare Set-Aside (MSA) Re-Review process. This “Amended Review” process is significant, as it actually provides those submitting MSAs for approval with an opportunity to revise and amend submitted MSA proposals upon an unfavorable determination from CMS. Previously, CMS has either been unwilling to re-review a submitted MSA or has limited its review following its determination. This has been
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