Conditional Payments

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...

CRC looks to resolve backload of conditional payment leads

On August 9, 2019, the Commercial Repayment Center (CRC) hosted a conference call to discuss the handling of conditional payment letters (CPL) versus conditional payment notices (CPN). On this call, the CRC announced...

Big reforms are coming to Michigan PIP - How the changes will impact Medicare Secondary Payer compliance

On May 30, 2019, Michigan Governor Gretchen Whitmer signed into law Michigan Senate Bill 1 (S.B. 1) [1] which makes significant changes to Michigan’s personal injury protection (PIP) system, including allowing policy...

Maryland Law Firm Reaches $250,000 Settlement with U.S. Department of Justice to Reimburse Medicare Conditional Payments

The United States Department of Justice (DOJ), United States Attorney’s Office for the District of Maryland has issued a news release reporting that a Maryland personal injury law firm has entered into a settlement fo...

CMS Hosts Medicare Secondary Payer Recovery Portal (MSPRP) Webinar

On August 16, 2018, the Centers for Medicare and Medicaid Services (CMS) hosted a webinar focusing on its Medicare Secondary Payer Recovery Portal (MSPRP). The MSPRP is CMS’ web-based application that enables authoriz...

Minor changes in newly released Medicare Secondary Payer Recovery Portal User Guide

The Centers for Medicare and Medicaid Services (CMS) has released an updated version of its Medicare Secondary Payer Recovery Portal (MSPRP) User Guide (Version 4.2). The changes are minor and primarily aimed at...

Law Firm Reaches Settlement with U.S. Department of Justice to Reimburse Medicare Conditional Payments and Start Internal MSP Compliance Program

The United States Department of Justice (DOJ) for the Eastern District of Pennsylvania has issued a news release reporting that a Philadelphia personal injury law firm has agreed to pay the government $28,000.00 to...

Eye on the courts: Florida’s collateral source rule does not apply to future Medicare payments

In an interesting new case in Florida, the court was called upon to address whether and how a plaintiff’s Medicare benefits should be considered in terms of evidence presented at trial. In Joerg v. State Farm Mutual...

A Recipe for Confusion: Medicare Conditional Payment Compliance in Asbestos-Related Workers' Compensation Claims

Medicare conditional payment compliance is difficult enough. When you add complex asbestos-related workers' compensation claims to the mix, it can create a recipe for confusion for insurance carriers, self-insureds, a...