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Medicare Secondary Payer (MSP)

Cms Future Medicals Teaser
November 9, 2022

Back to the drawing board: CMS’s future medicals proposals are withdrawn – where does this leave LMSAs?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in our October update, the Centers for Medicare and Medicaid Services’ (CMS’s) future medicals proposals have been withdrawn.

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August 18, 2022

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.

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June 30, 2022

Claims commitment: Empowering insurers on the innovation journey

The insurance industry has experienced tremendous change in the past few years.

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May 17, 2021

CMS updates Chapter 7 of the Medicare secondary payer (MSP) recovery manual

The Centers for Medicare and Medicaid Services (CMS) has released an update to Chapter 7 of its Medicare secondary payer (MSP) recovery manual.

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March 12, 2021

The COMP Act is reintroduced in the U.S. Senate

On 3/10/21, Senators Ben Cardin (D-MD) and Rob Portman (R-OH) introduced the Coordination of Medicare Payments and Workers’ Compensation Act (COMP Act) (S. 653) into…

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December 16, 2020

LMSA update: CMS’s “future medicals” proposals now scheduled for release in March 2021 | New LMSA case decision highlights continuing claims challenges

LMSA update: OIRA has issued an updated noticing indicating CMS’s “future medical” proposals are delayed again and projected for release in March 2021.

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November 10, 2020

Medicare conditional payment round-up

CMS has been quite active this year announcing several updates to its Medicare Secondary Payer Recovery Portal and holding a recent webinar on redetermination requests

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October 8, 2020

CMS releases updated Medicare Secondary Payer Recovery Portal user guide

On 10/5/20, CMS released an updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide. The changes update the claims listing interface to provide additional…

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September 10, 2020

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.”

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August 25, 2020

U.S. Department of Justice and plaintiff law firm reached a settlement to resolve a Medicare conditional payment claim

The DOJ’s Attorney’s Office for the Middle District of Pennsylvania has settled a Medicare conditional payment claim with the plaintiff law firm.

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July 14, 2020

CMS releases updated Medicare Secondary Payer Recovery Portal (MSPRP) user guide (Version 4.9)

CMS has released an updated Medicare Secondary Payer Recovery Portal User Guide (Version 4.9, July 13, 2020). CMS has made multiple updates to the MSPRP, which the agency…

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July 1, 2020

CMS’s expected release of its “future medicals” proposals now scheduled for August 2020

An updated notice from the Office of Information and Regulatory Affairs indicates CMS’s long-anticipated release of its “future medicals” notice of proposed rulemaking is…

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June 16, 2020

Key changes to Michigan PIP start July 1, 2020 – Medicare Secondary Payer compliance impact

While individuals will still be able to elect unlimited PIP coverage, for applicable policies issued or renewed after 7/1/20, PIP plans with different coverage limits may…

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March 30, 2020

Settling claims in unsettling times

In a time of social distancing and uncertainty, many are left wondering how our current working and social paradigm will impact workers’ compensation claims handling –…

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March 30, 2020

Social Security Administration suspends processing of third-party requests to determine SSDI status

As of 3/17/20, all the Social Security Administration field offices have been closed to the public in response to the growing COVID-19 pandemic according to its website.…

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