Settlements

South Carolina court: Medicare Advantage Plan can sue for “double damages” under the Medicare Secondary Payer statute

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...

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...

Seventh Circuit bypasses Medicare Advantage “double damages” question

The latest case addressing whether the Medicare Secondary Payer’s (MSP) private cause of action (PCA) statute [1] applies to Medicare Advantage Plans (MAP), thereby allowing MAPs to sue for double damages,” reached th...

Release of proposed “future medicals” rules will be delayed

New notice pushes back release date to October and makes other changes The Centers for Medicare and Medicaid Services’ (CMS) much anticipated release of proposed rules to address “future medicals” in relation to...

Massachusetts court: Medicare Advantage Plan’s assignee can sue for “double damages” under the MSP

In an interesting new case out of Massachusetts, the United States District Court in MSP Recovery Claims Series LLC v. Plymouth Rock Assurance Corporation , 2019 WL 3239277 (D. Massachusetts, July 18, 2019) found that...

CMS Releases New NGHP Section 111 User Guide

The Centers for Medicare and Medicaid Services (CMS) has updated its  Non-Group Health Plan (NGHP) Section 111 User Guide . The new guide is styled as Version 5.5 and is dated January 7, 2019. Per CMS, changes were ma...

Proposed Rules for Addressing Future Medical Obligations to be Released

The Office of Information and Regulatory Affairs (OIRA) recently issued a notice entitled Miscellaneous Medicare Secondary Payer Clarifications and Updates (CMS-6047-P) . This notice indicates that the Centers for...

CMS Retains $750 “Low Dollar” Threshold for 2019

The Centers for Medicare and Medicaid Services (CMS) has released its low dollar recovery threshold for 2019 via an alert dated November 15, 2018. CMS is generally required to publish an annual low dollar threshold...

Arizona Tweaks its "Full & Final" Workers' Comp Settlement Law - New Law Provides Opportunities to Settle Workers' Comp Claims

On October 31, 2017, Arizona Senate Bill (S.B.) 1332 became law allowing Arizona claims payers to reach “full and final” settlements of certain workers’ compensation (WC) claims. This new law provides Arizona insurers...