Mark Popolizio

Mark Popolizio

Mark Popolizio is the Vice President of MSP Compliance and Policy for ISO Claims Partners. Mark’s area of specialty is Medicare secondary payer compliance. He authors regular articles and provides educational presentations across the country on MSP issues. Mark's e-mail address is mpopolizio@iso.com.


    Posts by Mark Popolizio

    Court Blocks Medicare Discovery Requests – Ruling limits insurer’s ability to determine MMSEA obligations

    A new case out of Connecticut highlights complications insurers can encounter in obtaining information to assess their Medicare Secondary Payer (MSP) compliance obligations. In Silver v. Milford Medical Center Associates, 2017 WL 2452551 (Conn. Super. Ct. May 11, 2017), the court denied the defendant’s motion to file supplemental discovery requests to procure Medicare related information. […]

    New Ruling: Court Expands upon Its Recent Ruling Limiting CMS Recovery Rights

    The court in CIGA v. Price, 2017 WL 1737717 (C.D. California, May 3, 2017) has expanded upon its prior order limiting Medicare’s conditional payment rights. The case has garnered much industry attention, given its potential impact on the Centers for Medicare & Medicaid Services (CMS) recovery claims. The Case In this action, CIGA challenged CMS’ […]

    Exhaust Administrative Remedies Before Challenging Medicare Conditional Payment Claims

    A new case out of Missouri reaffirms this important principle: When challenging Medicare conditional payment claims, parties must exhaust Medicare administrative appeals before filing an action in federal court. This issue recently reappeared in Fortner v. Price (Secretary of Health and Human Services), 2017 WL 117712 (E.D. Missouri, March 30, 2017), a case in which […]

    New development hints at future MSA expansion to liability: CMS updates Common Working File for LMSAs and NFMSAs

    The Centers for Medicare and Medicaid Services (CMS) has issued a Change Request (CR-9893) to update its Common Working File (CWF) regarding Liability Medicare Set-Aside (LMSA) and No-Fault Medicare Set-Aside (NFMSA) Arrangements. CR-9893 is the latest in a string of recent releases signaling CMS’ possible expansion of MSAs to liability and other non-group health plans […]

    Seven Steps to closed: Maximizing Claims Settlement Projects

    There is a thin—and potentially costly—line between settling a claim and keeping it open. If that critical window is missed, claims can quickly nose-dive down a dark and expensive road. Implementing a well-coordinated claims settlement project can help insurers close multiple sets of claims much faster. Here are seven steps to help claims payers build […]

    Breaking: CMS Recovery Practice Ruled Improper under the MSP

    In an important new case—CIGA v. Burwell, 2017 WL 58821 (C.D. California, January 5, 2017)—the court ruled that the CMS practice of seeking full reimbursement of a medical provider’s single charge—even where some unsegregated portion of that charge relates to services not covered by a workers’ compensation plan—was improper under the Medicare Secondary Payer Statute […]