Medicare Advantage Plan (MAP)

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12/17/2019 - 16 min read

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.

12/5/2019 - 11 min read

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 assignee of a Medicare Advantage Plan (MAP) failed to allege sufficient facts to establish standing to pursue a private cause of action (PCA) claim for “double damages” against the defendant no-fault insurer under the Medicare Secondary Payer (MSP) statute.

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10/3/2019 - 9 min read

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 cause of action (PCA) statute.

8/21/2019 - 6 min read

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 standing grounds.

7/26/2019 - 9 min read

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.

7/11/2019 - 2 min read

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.

6/17/2019 - 8 min read

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.

5/22/2018 - 5 min read

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.

4/12/2018 - 2 min read

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.

3/21/2018 - 5 min read

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 MAPs enjoy private cause of action rights under the MSP.

3/19/2018 - 7 min read

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.

2/28/2018 - 7 min read

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.

1/12/2018 - 3 min read

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) statute remains a major concern for the claims industry.

11/27/2017 - 6 min read

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 recovery arena.

3/23/2017 - 2 min read

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.