Court Rules

Preparing for a Fundamental Compliance Shift in Liability Claims

As part of this series, we previously outlined the new dual threats of Medicare Advantage Plans (MAPs) and Liability Medicare Set-Asides (LMSAs). Liability claims are particularly at risk, as these...

MSP Statute Extends Its Reach in the 11th Circuit: Foreshadowing for Liability MSAs?

In our first blog post on this topic, we outlined the new and emerging risks and complications presented by Medicare Advantage Plans (MAPs). As previously indicated, the 11th Circuit Court of Appea...

The Impact of Medicare Advantage Plans on Your Claims: The Risk of Double Damages and Summary Judgment

As outlined in our previous blog post , the 11th Circuit Court in a 2-to-1 decision joined the Third Circuit in finding that Medicare Advantage Plans do have private cause of action rights under th...

Breaking News: 11th Circuit Rules Medicare Advantage Plans Can Sue in Federal Court

In a broad ruling released on August 8, the Eleventh Circuit Court of Appeals expanded the rights of Medicare Advantage Organizations (MAOs) to use Federal Court to sue primary payers and receive...

New Front in Medicare Advantage Battle: Law Firm Targeted

We continue to watch closely the expansion of Medicare Secondary Payer (MSP) recovery concepts to cases involving Medicare Advantage Plans (MAPs). Now, an important new MAP decision has been reache...

Settlement Language Strikes Again New Case Proves Clear Provisions Are Critical

Settlement language is an important aspect of Medicare Secondary Payer (MSP) claims that demands careful consideration. When settlements fail to address key MSP issues or neglect to reflect payer...

When Can I Use My WCMSA? Misunderstanding As to “When” the WCMSA Becomes Effective Ends Up Vacating Settlement

In McCarroll v. Livingston Parish Council , 2014 WL 5439624, -- So.3d – (La. App. 1 st Cir., October 27, 2014), the parties believed that the claimant could use his approved WCMSA fund to cover a...

Court Rules That Employer Does Not Have to Fund Higher WCMSA Amount

In Hunter v. Rapides Parish School Board , No. 14-490, 2014 WL 5669206 (La. App. 3 rd  , Nov. 5, 2014), the Louisiana appeals court held that the employer was not required to fund a counter-higher...

Court Allows Medicare Advantage Plan’s Suit for Double Damages to Proceed

In an important development on the Medicare Advantage (MA) front, the court in Humana v. Farmers Texas County Mutual Insurance Company, et. al , No. 13-CV-611-LY (W.D. Texas, September 24, 2014)...