Mark Popolizio

11/14/2022 - 1 min read

CMS to hold NGHP Section 111 Webinar on December 6th at 1:00 p.m. ET

The Centers for Medicare and Medicaid Services (CMS) has announced that it will be holding a non-group health plan (NGHP) Section 111 webinar.

11/9/2022 - 14 min read

Back to the drawing board: CMS’s future medicals proposals are withdrawn – where does this leave LMSAs?

As reported in our October update, the Centers for Medicare and Medicaid Services’ (CMS’s) future medicals proposals have been withdrawn.

11/3/2022 - 10 min read

CMS releases data and statistics regarding CRC recoveries and WCMSAs

The Centers for Medicare and Medicaid Services (CMS) has released two new reports providing data regarding CRC recoveries and WCMSAs.

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”

10/14/2022 - 1 min read

CMS’s future medicals proposals have been withdrawn

In an important new development, an updated Office of Information and Regulatory Affairs (OIRA) notice reflects that CMS has withdrawn its “future medicals” proposals.

10/4/2022 - 7 min read

CMS releases Section 111 NGHP User Guide (Version 6.9) – updates relate to Section 111 excluded/valid diagnosis codes for 2023, SP31 error, and other items

8/18/2022 - 29 min read

The U.S. Eleventh Circuit Court of Appeals applies a four-year statute of limitations to an MSP private cause of action claim – dismisses action as untimely

In an important new MSP decision, the U.S. Circuit Court of Appeals for the Eleventh Circuit in MSPA Claims 1, LLC v. Tower Hill Prime Insurance Co.

7/12/2022 - 28 min read

Illinois enacts the “Consumer Legal Funding Act” -- new law regulates various aspects of third-party litigation funding practices

In a significant development on the TPLF front, on May 27, 2022, Illinois Governor J.B. Pritzker (D) signed into law the Consumer Legal Funding Act.

7/12/2022 - 14 min read

Delaware’s State Senate passes concurrent resolution encouraging the Delaware Judiciary to study possible third-party litigation funding (TPLF) disclosure rules

In an interesting development to watch, on June 28, 2022, the Delaware State Senate passed Delaware Senate Concurrent Resolution No. 127.

6/24/2022 - 15 min read

The RAMP Act is introduced in Congress – proposed bill aims to repeal Medicare’s private cause of action (“double damages”) statute

6/10/2022 - 25 min read

The United States Supreme Court rules that Medicaid may seek recovery from settlement payments representing future medical care

The Court rejected the plaintiff’s argument that Medicaid’s recovery was limited to only that portion of the settlement representing past medical care.

5/11/2022 - 22 min read

Seventh Circuit dismisses the Illinois Fund’s challenge to Section 111 reporting -- holds that administrative remedies must first be exhausted before the court has jurisdiction

In Illinois Insurance Guaranty Fund v. Becerra, 2022 WL 1438506 7th Cir. May 6, 2022, the United States Seventh Circuit Court of Appeals affirmed a lower court decision.

3/11/2022 - 1 min read

Medicare Secondary Payer recovery debts can now be paid using automated clearing house transactions

CMS has released a notice advising that MSP recovery debts may now be paid using ACH transactions.

3/3/2022 - 11 min read

CMS on the move: Section 111 civil money penalties Final Rule and Future Medicals proposals are pending review for release

The OIRA website indicates that CMS’s long-awaited S111 CMP “final rule” and their “Future Medicals” proposals are completed and are now pending OIRA review for release.

2/18/2022 - 12 min read

CMS holds WCMSA webinar CMS discusses non-submit/EBMSAs, allocation pricing, denials, and other important WCMSA topics

On February 17, 2022 the Centers for Medicare and Medicaid Services (CMS) held a webinar session to address workers’ compensation Medicare set-aside (WCMSA) issues.

Mark Popolizio, J.D.

CMS to hold NGHP Section 111 Webinar on December 6th at 1:00 p.m. ET

Back to the drawing board: CMS’s future medicals proposals are withdrawn – where does this leave LMSAs?

CMS releases data and statistics regarding CRC recoveries and WCMSAs

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

CMS’s future medicals proposals have been withdrawn

CMS releases Section 111 NGHP User Guide (Version 6.9) – updates relate to Section 111 excluded/valid diagnosis codes for 2023, SP31 error, and other items

The U.S. Eleventh Circuit Court of Appeals applies a four-year statute of limitations to an MSP private cause of action claim – dismisses action as untimely

Illinois enacts the “Consumer Legal Funding Act” -- new law regulates various aspects of third-party litigation funding practices

Delaware’s State Senate passes concurrent resolution encouraging the Delaware Judiciary to study possible third-party litigation funding (TPLF) disclosure rules

The RAMP Act is introduced in Congress – proposed bill aims to repeal Medicare’s private cause of action (“double damages”) statute

The United States Supreme Court rules that Medicaid may seek recovery from settlement payments representing future medical care

Seventh Circuit dismisses the Illinois Fund’s challenge to Section 111 reporting -- holds that administrative remedies must first be exhausted before the court has jurisdiction

Medicare Secondary Payer recovery debts can now be paid using automated clearing house transactions

CMS on the move: Section 111 civil money penalties Final Rule and Future Medicals proposals are pending review for release

CMS holds WCMSA webinar CMS discusses non-submit/EBMSAs, allocation pricing, denials, and other important WCMSA topics