Mark Popolizio, J.D.
A recipe for confusion: Medicare conditional payment compliance in asbestos-related workers' compensation claims
Medicare conditional payment compliance is difficult enough. When you add complex asbestos-related workers' compensation claims to the mix, it can create a recipe for…
Preparing for mediation: Medicare checklist for WC claims
It is no secret that Medicare Secondary Payer compliance continues to complicate workers' compensation claims practice. Unfortunately, far too often Medicare issues…
Section 111 level set changes, updates and watch list items for 2015
It has been roughly seven years since the Section 111 reporting requirements were enacted into law. During this time, the industry has witnessed and worked through…
Court: Medicare Advantage Organization can pursue reimbursement against its enrollee
In an important new Medicare Advantage case, the court in Collins v. Wellcare Healthcare Plans, Inc., No. 13-6759, 2014 WL 7239426 (E.D. La December 16, 2014) ruled that…
Medicare Advantage update: Court rejects Humana’s request for class certification
In the case In re Avandia, MDL No. 1871, 2014 WL 6684343 (E.D. Pennsylvania, Nov. 24, 2014),1 the United States District Court denied Humana’s request for class…
CMS releases new Section 111 alert regarding SSNs
CMS has released a new NGHP Section 111 alert providing additional information regarding its plans to allow RREs to submit partial social security numbers (SSNs) for…
When can I use my WCMSA?
In McCarroll v. Livingston Parish Council, 2014 WL 5439624, -- So.3d – (La. App. 1st Cir., October 27, 2014), the parties believed that the claimant could use his…
Court rules that employer does not have to fund higher WCMSA amount
In Hunter v. Rapides Parish School Board, No. 14-490, 2014 WL 5669206 (La. App. 3rd , Nov. 5, 2014), the Louisiana appeals court held that the employer was not required…
Preparing for the ICD-10 Transition
CMS released an alert in May 2014 announcing that the ICD-10 diagnosis codes reporting for Section 111 is postponed until October 1, 2015.
Major Medicare reforms become law — Are you ready?
In a major development on the Medicare front, President Obama has signed the Strengthening Medicare and Repaying Taxpayers (SMART) Act into law.