Casualty Solutions

6/7/2023 - 8 min read

The RAMP Act is re-introduced in Congress – bill proposes revisions to the MSP’s private cause of action (“double damages”) provision

On 5/16/23, (RAMP) Act was re-introduced into the U.S. House of Representatives, bill proposes revisions to the MSP’s private cause of action provision.

5/24/2023 - 13 min read

The Highway Accident Fairness Act of 2023 (H.R. 2936) is introduced into Congress – bill prohibits staged accidents with commercial vehicles and includes TPLF disclosure provisions

In general, H.R. 2936 would amend title 49, United States Code, to “prohibit staged collisions with commercial motor vehicles, and for other purposes.”

Gavel on a white background with a small shadow.

5/23/2023 - 9 min read

The United States District Court for Massachusetts dismisses a Medicare Advantage claim for “double damages” – rules that insurer’s Section 111 reporting does not establish standing to sue

The U.S. District Court for Massachusetts dismisses Medicare Advantage claim for “double damages”—rules insurer’s Section 111 reporting doesn't establish standing to sue.

5/18/2023 - 4 min read

CMS releases the WCMSA Reference Guide Version 3.9

CMS has made various updates to different aspects of its WCMSA process, including removing the time limit on Amended Reviews.

5/16/2023 - 16 min read

Harnessing AI and ML through Discovery Navigator to save time and money on medical records review

Understand the vital role of AI in automating record reviews and how it addresses current industry challenges.

5/3/2023 - 6 min read

CMS releases Non-Group Health Plan (NGHP) Applicable Plan Appeals Reference Guide (Version 1.0)

The Centers for Medicare and Medicaid Services (CMS) has released a Non-Group Health Plan (NGHP) Applicable Appeals Reference Guide (Version 1.0, April 27, 2023).

5/1/2023 - 10 min read

CMS’s Query Process and non-binary/unspecified gender designations – current issues and considerations

Section 111 non-group health plan (RREs) involves the inability to submit non-binary or unspecified gender designations as part of the (CMS’s)

4/26/2023 - 18 min read

The Eleventh Circuit dismisses a Medicare Advantage “double damages” lawsuit – court rules the MSP statute does not preempt insurer's claims-filing deadline or Florida’s no-fault pre-suit demand

In a recent Medicare Advantage recovery action, the United States Eleventh Circuit Court of Appeals in MSP Recovery Claims.

4/26/2023 - 1 min read

Starting April 29, 2023, CMS Will Use the 2020 CDC Life Table for WCMSAs

The (CMS) has announced that beginning April 29, 2023, it will use the new 2020 CDC Life Table to calculate adjusted life expectancies in (WCMSAs).

4/25/2023 - 3 min read

CMS releases Section 111 NGHP User Guide (Version 7.1, April 24, 2023)

The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 NGHP User Guide (Version 7.1, April 24, 2023)

4/25/2023 - 17 min read

Second Circuit dismisses Medicare Advantage “double damages” lawsuit on standing grounds – rules the insurer’s Section 111 reporting did not establish liability

In an interesting new Medicare Advantage recovery decision, the United States Second Circuit Court of Appeals in MSP Recovery Claims.

3/31/2023 - 12 min read

Changing of the Guard: Detail Claim Information (DCI) is sunsetting and the Indemnity Data Call (IDC) will take over – what you should know

The DCI is now scheduled to sunset at the end of December 2023 and is being replaced by the Indemnity Data Call (IDC).

3/29/2023 - 9 min read

Florida (and other states) take aim at regulating Third-Party Litigation Funding

With the state legislative season in full-swing, Florida, along with several other states, has introduced legislation focused on regulating (TPLF).

3/21/2023 - 25 min read

Waiting for CMS’s Section 111 penalties “final rule” – status, updates, and what’s next

Presently, the industry is waiting for CMS to release its Section 111 CMPs “final rule” to the public.

3/17/2023 - 1 min read

Medicare’s Commercial Repayment Center (CRC) updates mailing address for Non-Group Health Plan (NGHP) Medicare Secondary Payer (MSP) correspondence