Settlements

Illinois court dismisses Medicare Advantage Plan suit for “double damages” on standing grounds

In MAO-MSO Recovery II, LLC v. State Farm , 2019 WL 6311987 (C.D. Ill. Nov. 25, 2019), [1] the United States District Court for the Central District of Illinois found that an assignee of a Medicare Advantage Plan (MAP...

CMS retains its $750 “Low Dollar” threshold for 2020

The Centers for Medicare and Medicaid Services (CMS) has released its low dollar recovery threshold for 2020 via a new alert . CMS is generally required to publish an annual low dollar threshold amount according to...

Litigation insights offer the key to rising claim costs

Insurers are constantly seeking ways to enhance efficiency and contain costs in claims operations. Sure, technology has helped streamline processes and reduce some expenses, but many carriers still struggle to manage...

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...