Medicare Compliance Blog

The Sunk-Costs Trap in Claims

It’s hard to imagine that flying used to be glamorous, but for those who remember the Concorde, they know it was the epitome of glamour. The supersonic jet flew at 60,000 feet—high enough for you to see the Earth’s curvature—and could blast you from Paris to New York in three and a half hours. Think about that the next time you are in row 52, next to a hungover college student who poured himself into his seat after a 168-hour non-stop spring break party visiting his friends abroad.

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An Existential Crisis?

We are in a time of crisis, whether we want to believe it or not. Our industry has resisted disruptive innovation for years.
We think because we use email, have a firm website, subscribe to Westlaw, purchased some data-storage software, or use PowerPoint (occasionally) that we’re up to date; that we’re tech-savvy; that we’re consistent with (if not ahead of) the trends. But we are not.
The frank reality is that lawyers are only a few steps removed from communicating with carrier pigeons, wearing powdered wigs, and dipping a quill pen into an inkwell. It’s time to shake things up.

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Seasons of Change

Whether your preferred end-of-summer pop-culture reference is Danny Zuko and Sandy Olsson pining for each other at opposite ends of Rydell High, Frances “Baby” Houseman being hoisted into the air, or the sound of the “60 Minutes” clock signaling that it’s Sunday night, and, in a few hours, it will be time for school, it’s always the same story: Summer has to end.

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“Rethinking Our Approach: Are we getting it wrong when it comes to defending clients and insurers?”

A client has hired you to offer sound, legal advice; to represent him zealously. Naturally, as an esteemed lawyer, you rely upon your years of experience, historical judgment, and legal acumen. The client is looking for guidance or even assurances. Your legal muscle memory kicks into action, and you approach the problem the way you have time and time again throughout your career.

Read More »

What is a demand letter?

Suppose you are a Medicare beneficiary who has been awarded a settlement from your case or claim. In that case, you may receive a demand letter from CMS. When a claim is settled, the Responsible Reporting Entity (“RRE”) should report settlement information

Read More »

Get to Know Medicare Advantage Plans

What Are They? Medicare Advantage Plans (MAPs), also referred to as “Part C” plans, are offered by private insurance companies contracting with Medicare to provide coverage to beneficiaries.

Read More »

The Sunk-Costs Trap in Claims

It’s hard to imagine that flying used to be glamorous, but for those who remember the Concorde, they know it was the epitome of glamour. The supersonic jet flew at 60,000 feet—high enough for you to see the Earth’s curvature—and could blast you from Paris to New York in three and a half hours. Think about that the next time you are in row 52, next to a hungover college student who poured himself into his seat after a 168-hour non-stop spring break party visiting his friends abroad.

Read More »

An Existential Crisis?

We are in a time of crisis, whether we want to believe it or not. Our industry has resisted disruptive innovation for years.
We think because we use email, have a firm website, subscribe to Westlaw, purchased some data-storage software, or use PowerPoint (occasionally) that we’re up to date; that we’re tech-savvy; that we’re consistent with (if not ahead of) the trends. But we are not.
The frank reality is that lawyers are only a few steps removed from communicating with carrier pigeons, wearing powdered wigs, and dipping a quill pen into an inkwell. It’s time to shake things up.

Read More »

Seasons of Change

Whether your preferred end-of-summer pop-culture reference is Danny Zuko and Sandy Olsson pining for each other at opposite ends of Rydell High, Frances “Baby” Houseman being hoisted into the air, or the sound of the “60 Minutes” clock signaling that it’s Sunday night, and, in a few hours, it will be time for school, it’s always the same story: Summer has to end.

Read More »

“Rethinking Our Approach: Are we getting it wrong when it comes to defending clients and insurers?”

A client has hired you to offer sound, legal advice; to represent him zealously. Naturally, as an esteemed lawyer, you rely upon your years of experience, historical judgment, and legal acumen. The client is looking for guidance or even assurances. Your legal muscle memory kicks into action, and you approach the problem the way you have time and time again throughout your career.

Read More »

What is a demand letter?

Suppose you are a Medicare beneficiary who has been awarded a settlement from your case or claim. In that case, you may receive a demand letter from CMS. When a claim is settled, the Responsible Reporting Entity (“RRE”) should report settlement information

Read More »

Get to Know Medicare Advantage Plans

What Are They? Medicare Advantage Plans (MAPs), also referred to as “Part C” plans, are offered by private insurance companies contracting with Medicare to provide coverage to beneficiaries.

Read More »