Medicare Advantage Plan (MAP)
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”
Claims commitment: Empowering insurers on the innovation journey
The insurance industry has experienced tremendous change in the past few years.
11th Circuit rules Medicare Advantage downstream entities can sue for double damages under MSP’s PCA provision
The 11th Circuit has ruled “downstream entities”, which Medicare Advantage Plans contract with to help provide benefits, can sue primary plans for “double damages.”
Connecticut court rules Medicare Advantage Plan entitled to double damages
The U.S. District Court for Connecticut in Aetna v. Guerrera, 2020 ruled, in part, the alleged self-insured supermarket was a primary plan and liable for “double damages”…
The Eleventh Circuit rules that the MSP’s three-year “claims-filing” statute is not a prerequisite for filing a private cause of action recovery claim
In reversing a lower court decision, the U.S. Circuit Court of Appeals (Eleventh Circuit) in MSPA Claims 1, LLC v. Kingsway Amigo Insurance ruled compliance with the…
California spotlight: Medicare Advantage recovery rights
The issue of Medicare Advantage Plans recovery rights has catapulted to the compliance forefront over the past few years following a series of court rulings finding that…
Ohio court rules that Medicare Advantage Plans can sue insurers for “double damages” under the MSP
The U.S. District Court in Ohio ruled MAPs can sue insurers for “double damages” under the MSP.
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), the United States District Court for the Central District of Illinois found that an…
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…
Seventh Circuit bypasses Medicare Advantage “double damages” question
The Seventh Circuit affirmed (with modification) a ruling from the U.S. District Court for the Central District of Illinois dismissing a MAP assignee’s PCA claim on…
Massachusetts court: Medicare Advantage Plan’s assignee can sue for “double damages” under the MSP
Massachusetts is the latest jurisdiction to take a favorable view of MAPs possessing private cause of action rights under the Medicare Secondary Payer.
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.
Florida court: No-fault pre-suit notice requirement must be followed before Medicare private cause of action claim can proceed
In a new Florida decision, the U.S. District Court in ruled Florida’s no-fault pre-suit notice requirement must be satisfied before a PCA action can proceed.
Arizona tweaks its "full & final" workers' comp settlement law - New law provides opportunities to settle workers' comp claims
Arizona Senate Bill 1100 provides unprecedented opportunities to settle workers' compensation claims in the state.
CMS issues new regulations aimed at identifying and limiting potential opioid abuse
On April 2, 2018, C,S issued a final rule which updated regulations for Medicare Advantage Plans (MAP) and Medicare Part D programs.