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.

Ninth Circuit: CIGA is not a “primary payer” under the MSP and does not have to reimburse Medicare

In a significant new case out of California, the United States Circuit Court of Appeals (Ninth Circuit) [1] in California Insurance Guarantee Association (CIGA) v. Azar , 2019 WL 5076945 (9 th Cir. Oct. 10, 2019)...

South Carolina court: Medicare Advantage Plan can sue for “double damages” under the Medicare Secondary Payer statute

The South Carolina District Court is the latest jurisdiction presented with the question of whether a Medicare Advantage Plan (MAP) can sue for “double damages” under the Medicare Secondary Payer’s (MSP’s) private cau...

CMS’ Section 111 Penalty Proposals Are One Step Closer

A new release from the Office of Information and Regulatory Affairs (OIRA) indicates that the Centers for Medicare and Medicaid Services (CMS) is one step closer to releasing its much-anticipated Section 111 reporting...

The new indemnity data call – are you ready?

As the fourth quarter settles in, a big change is lurking around the corner: The National Council on Compensation Insurance’s (NCCI) new indemnity data call.  Introduced last year, this initiative is scheduled to laun...

Proposed Workers’ Compensation Medicare Set Aside Reform Bill Filed in the U.S. House of Representatives

On August 2, 2019, Representatives Mike Thomson (D-CA) and George Holding (R-NC) introduced legislation aimed at reforming the Centers for Medicare and Medicaid Services’ (CMS) Workers’ Compensation Medicare Set-Aside...

Seventh Circuit bypasses Medicare Advantage “double damages” question

The latest case addressing whether the Medicare Secondary Payer’s (MSP) private cause of action (PCA) statute [1] applies to Medicare Advantage Plans (MAP), thereby allowing MAPs to sue for double damages,” reached th...

Release of proposed “future medicals” rules will be delayed

New notice pushes back release date to October and makes other changes The Centers for Medicare and Medicaid Services’ (CMS) much anticipated release of proposed rules to address “future medicals” in relation to...

WCMSA RX Update – FDA approves first generics of Lyrica

In a July 22, 2019 news release , the Food and Drug Administration (FDA) announced that it has approved the first generics of Lyrica. This announcement comes at a critical time as the Centers for Medicare and Medicaid...

Massachusetts court: Medicare Advantage Plan’s assignee can sue for “double damages” under the MSP

In an interesting new case out of Massachusetts, the United States District Court in MSP Recovery Claims Series LLC v. Plymouth Rock Assurance Corporation , 2019 WL 3239277 (D. Massachusetts, July 18, 2019) found that...

CMS releases new NGHP Section 111 User Guide (Version 5.6)

The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 User Guide (Version 5.6, July 1, 2019 ) regarding non-group health plans (liability, no-fault and workers’ compensation). This...