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)...
Conditional Payments
Ninth Circuit: CIGA is not a “primary payer” under the MSP and does not have to reimburse Medicare
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October 11, 2019
Conditional Payment Updates | Open Debt Reports are back; Pre-PCN worksheets are on hold; and CRC will continue to review all CPL disputes
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October 7, 2019
There has been a flurry of recent activity from the Centers for Medicare and Medicaid Services (CMS) and the Commercial Repayment Center (CRC) regarding processing of conditional payment claims. The new CMS and CRC...
South Carolina court: Medicare Advantage Plan can sue for “double damages” under the Medicare Secondary Payer statute
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October 3, 2019
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...
Proposed Workers’ Compensation Medicare Set Aside Reform Bill Filed in the U.S. House of Representatives
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August 27, 2019
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
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August 22, 2019
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
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June 17, 2019
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
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March 21, 2019
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
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August 17, 2018
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...
Law Firm Reaches Settlement with U.S. Department of Justice to Reimburse Medicare Conditional Payments and Start Internal MSP Compliance Program
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June 20, 2018
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
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November 16, 2015
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...