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Medicare Advantage Plan (MAP)

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August 21, 2019

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…

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July 26, 2019

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.

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July 11, 2019

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.

Gavel2
June 17, 2019

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.

Files
May 22, 2018

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.

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April 12, 2018

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.

Stethoscope
March 21, 2018

Texas court: Medicare Advantage Plans can sue for private cause of action under the Medicare Secondary Payer statute

This ruling by the federal district court for the Southern District of Texas places it in line with a growing number of decisions from other jurisdictions finding that…

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March 19, 2018

Medicare Advantage update: Connecticut court rules MAPs can pursue “double damages” under the Medicare Secondary Payer statute

Connecticut is the latest jurisdiction to address whether MAPs have private cause of action (PCA) rights to pursue “double damages” under the MSP statute.

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February 28, 2018

Medicare watch list: Staying ahead of the Medicare Secondary Payer compliance curve

As another new year settles in, we know at least one thing is certain: MSP compliance will continue to present formidable challenges for claims payers.

Gavel
January 12, 2018

Medicare Advantage Plans update: Illinois court indicates MAPs have “double damages” rights

Whether Medicare Advantage Plans have private cause of action rights to sue claims payers (and others) for “double damages” under the Medicare Secondary Payer (MSP)…

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November 27, 2017

Medicare Part D - The next recovery frontier?

Spurred by a number of favorable court decisions allowing MAPs to sue for “double damages” under the MSP statute, Medicare Part D plans are now beginning to step into the…

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March 23, 2017

SPARC Act reintroduced in Congress

The SPARC Act seeks to ensure that Medicare Part D is adequately reimbursed when another entity is determined to be the primary payer.

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March 20, 2017

2017 Medicare watch list

It’s clear there will be no shortage of Medicare Secondary Payer developments to keep an eye on this year. Here’s an outline of MSP events to watch in 2017.

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November 11, 2016

Removing roadblocks to settlements: Medicare Part C claims in the way of your settlement

The last half-dozen years have seen Medicare Secondary Payer (MSP) compliance evolve, with the most recent example being its change in focus from mandatory insurer…

Gavel
September 29, 2016

The SPARC Act may have implications for future Medicare Advantage Plan rulings

On September 22, Congressmen Tim Murphy (R-PA) and Ron Kind (D-WI) introduced legislation designed to clarify the Medicare Secondary Payer (MSP).

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