Cattie & Gonzalez, PLLC

Our managing partner, ⚖️John V. Cattie, Jr. has a special holiday message for all of you on behalf of the firm! #Holidays #ChristmasTree #Lights

We want to take this chance to say Merry Christmas & Happy Holidays from everyone here at the firm! We hope you get to spend lots of time with loved ones and friends, open lots of gifts, and drink lots of eggnog. #Christmas #Eggnog #TimeOff

Examples of When Responsible Reporting Entities (RREs) Will Be Subject to MSP Civil Money Penalty (CMP): "An individual not yet a Medicare beneficiary has a serious accident at work on 2/1/2025, and the RRE assumed payment responsibility from the date of the accident, 2/1/2025. The individual becomes a Medicare beneficiary effective 5/1/2025. The RRE reports ORM on 4/15/2026." Because the RRE reported Ongoing Responsibility for Medical (ORM) within 365 days of the beneficiary's Medicare entitlement date, the RRE is compliant and not subject to a penalty with respect to this ORM. #CMP #RRE #Medicare

Today's the day! You can still register up until 3pm EST. Hope you can join us! Visit the registration link in the original post. #Webinar #Free #Medicare

It's almost here! Have you registered for our free webinar yet? Join ⚖️John V. Cattie, Jr., Rafael Gonzalez, Esq., & James M (Jim) Anderson as they speak about Medicare Mandatory Insurer Reporting Audits and Avoiding Civil Monetary Penalties on December 19th 2024, 3pm-4pm EST/12pm-1pm PST! To register, make sure you have a valid Zoom account! https://lnkd.in/eDt_AdG3 #Webinar #Medicare #CMP

Examples of When Responsible Reporting Entities (RREs) Will Not be Subject to Medicare Secondary Payer (MSP) Civil Money Penalty (CMP): "A Medicare beneficiary’s product liability claim is settled on 2/1/2025, but the settlement amount and funding are not finalized until 12/1/2025. The RRE reports the Total Payment Obligation to Claimant (TPOC) date as 2/1/2025 and Funding Delayed Beyond TPOC Date as 12/1/2025, and the record is successfully reported to CMS on 7/1/2026." Although the RRE reported the settlement more than 365 days after the original settlement date, because the RRE reported TPOC within 365 days of the later funding delayed date, the RRE is compliant and not subject to a penalty with respect to this TPOC. #CMP #RRE #Medicare

Examples of When Responsible Reporting Entities (RREs) Will Be Subject to MSP Civil Money Penalty (CMP): "A beneficiary has an auto accident on 2/1/2025 and reports the claim to the no-fault carrier on 5/1/2025. The RRE assumes responsibility for medical care immediately for the alleged injuries from the date of the accident (2/1/2025). A settlement is subsequently reached on 10/15/2025 and the RRE reports Ongoing Responsibility for Medical (ORM) termination and Total Payment Obligation to Claimant (TPOC) on 5/15/2026." Because the RRE reported ORM more than 365 days after it learned of the accident, the RRE is subject to a CMP for the period between 5/2/2026 – 5/15/2026, totaling 13 days at $250 per day, or as adjusted for inflation, equals a CMP minimum of $3,250. #CMP #RRE #Medicare

Over the last decade, Medicare Advantage, the private plan alternative to traditional Medicare, has taken on a more prominent role in the Medicare program. As a result, enrollees, insurers, providers, and their legal representatives continue to see more Medicare Advantage involvement in liability, no-fault, and workers compensation claims and litigated cases. Whether recouping conditional payments previously made by the Medicare Advantage plan related to the claim before settlement, or asserting their future interest by denying care or seeking reimbursement of post settlement payments made by the Advantage plan related to the injuries associated with the claimed accident, because of the millions of enrollees in the Medicare Advantage system and therefore the billions of dollars at stake, keeping up with details, numbers, and trends in the Medicare Advantage space has become increasingly more important to all property and casualty stakeholders. My Medicare & Medicaid Update Newsletter 7 is a verbatim rendition of Kaiser Family Foundation (KFF) research, data, studies, statistics, analysis, observations, conclusions, and recommendations published throughout 2024. It provides an overview of the Medicare Advantage plans that are available for 2025 and key trends over time. It also provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2025 and key trends over time. https://lnkd.in/g55dzzbH #rafaelgonzalezesq #medicaremedicaidupdate #cattiegonzalezpllc #ahigherstandardinmspcompliance www.cattielaw.com info@cattielaw.com 844.546.3500

The countdown to our next webinar is on! Make sure you register, completely free. #Webinar #Medicare #Free

Examples of When Responsible Reporting Entities (RREs) Will Not be Subject to Medicare Secondary Payer (MSP) Civil Money Penalty (CMP): "A Medicare beneficiary has an auto accident on 2/1/2025 and reports the claim to the carrier on 5/1/2025. The No-Fault RRE assumes Ongoing Responsibility for Medical (ORM) from the date of the accident, 2/1/2025. The RRE reports ORM on 10/15/2025." Because the RRE reported ORM within 365 days of the date when it assumed ORM, the RRE is compliant and not subject to a penalty with respect to this ORM. #CMP #RRE #Medicare