Medicare Part D

Ninth Circuit: CIGA is not a “primary payer” under the MSP and does not have to reimburse Medicare

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)...

PAID Act Introduced in the U.S. Senate

On June 26, 2019, Senators Tim Scott (R-SC) and Ben Cardin (D-MD) introduced Senate Bill 1989 into the U.S. Senate. Section one of this bill states the Act may be cited as the Provide Accurate Information Directly (PA...

PAID Act Reintroduced in 116th Congress

On February 26 th , Congressmen Ron Kind (D-WI) and Guy Bilirakis (R-FL) reintroduced the Provide Accurate Information Directly (PAID) Act as H.R. 1375 into the U.S. House of Representatives. This bi-partisan bill was...

Top 10 Medicare Secondary Payer Trends in 2019

Medicare Secondary Payer (MSP) compliance is a rapidly evolving area that has experienced significant changes in recent years, and 2019 looks to be no different. Policy changes, stricter regulations, new legislation,...

CMS Updates its Medicare Prescription Drug Benefit Manual – New Changes Encourage Part D Collection and Recovery

The Centers for Medicare and Medicaid Services (CMS) has amended its Medicare Prescription Drug Benefit Manual (Part D Manual) to add, in part, stronger language regarding Medicare Part D sponsors’ secondary payer...

CMS Issues New Regulations Aimed at Identifying and Limiting Potential Opioid Abuse

On April 2, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a final rule which updated regulations for Medicare Advantage Plans (MAP) and Medicare Part D programs. The primary focus of the updates is...

Medicare Part D - The Next Recovery Frontier?

Medicare Secondary Payer (MSP) compliance has historically focused on the interests of traditional Medicare (that is, Medicare Parts A and B). In the wake of the recent In Re Avandia decision out of the United States...