Medicare Advantage Plan (MAP)

8/21/2024 - 2 min read

New WCMSA Self-Admin Tool Kit – CMS updates on MAP and Part D plans

CMS releases updated WCMSA Self-Administration Tool Kit (v1.6), with key updates on Medicare Part C, MAP, and Part D plans.

7/18/2024 - 2 min read

Mid-Year “Round-Up” 2024 – tracking Medicare and claims updates

Stay updated on 2024’s key claim trends: Medicare changes, Section 111 penalties, TPOC/WCMSA reporting, MSAs, FROI/SROI, TPLF, and more.

6/17/2024 - 21 min read

The U.S. District Court for Maryland rules that MAPs can sue insurers for “double damages"

Maryland District Court: MAPs and related entities can sue insurers for "double damages" under the MSP statute's PCA provision.

8/10/2023 - 20 min read

United States District Court for Massachusetts rules that a MAP assignee has standing

New Medicare Advantage recovery case, the US District Court for MA in MSP Recovery Claims Series 44, LLC v. Bunker Hill Insurance Company, 2023 WL 4744739 two questions

8/7/2023 - 12 min read

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

Interesting new Medicare Advantage recovery case, the United States District Court for Connecticut in MSP Recovery Claims, Series LLC v. Travelers Indemnity Company

6/28/2023 - 10 min read

Mid-Year “Round-Up” 2023 – keeping track of Medicare and other claims updates (ICYMI)

We are at the mid-point for 2023! It has been a busy year in so many claims areas. Time to regroup on the key claims updates over the past months – ICYMI style!

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.

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.

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.

10/31/2022 - 22 min read

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages” – ruling affirms the district court’s award of double damages against insurer

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages”

6/30/2022 - 2 min read

Claims commitment: Empowering insurers on the innovation journey

The insurance industry has experienced tremendous change in the past few years.

9/10/2020 - 12 min read

11th Circuit rules Medicare Advantage downstream entities can sue for double damages under MSP’s PCA provision

The 11th Circuit has ruled “downstream entities”, which Medicare Advantage Plans contract with to help provide benefits, can sue primary plans for “double damages.”

8/7/2020 - 17 min read

Connecticut court rules Medicare Advantage Plan entitled to double damages

The U.S. District Court for Connecticut in Aetna v. Guerrera, 2020 ruled, in part, the alleged self-insured supermarket was a primary plan and liable for “double damages” for its failure to reimburse Aetna’s Medicare Advantage Plan recovery claim.

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2/27/2020 - 14 min read

The Eleventh Circuit rules that the MSP’s three-year “claims-filing” statute is not a prerequisite for filing a private cause of action recovery claim

In reversing a lower court decision, the U.S. Circuit Court of Appeals (Eleventh Circuit) in MSPA Claims 1, LLC v. Kingsway Amigo Insurance ruled compliance with the Medicare Secondary Payer’s “claims-filing” statute was not a prerequisite for filing a private cause of action recovery claim.

2/12/2020 - 21 min read

California spotlight: Medicare Advantage recovery rights

The issue of Medicare Advantage Plans recovery rights has catapulted to the compliance forefront over the past few years following a series of court rulings finding that MAPs can sue claims payers for “double damages” under the Medicare Secondary Payer private cause of action provision.