Currently, there are two questions being litigated that involve who can sue under the Medicare Secondary Payer’s (MSP) private cause of action (PCA) provision and when…
Connecticut is the latest jurisdiction to address whether MAPs have private cause of action (PCA) rights to pursue “double damages” under the MSP statute.
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.
This brief government shutdown did not affect Medicare Secondary Payer operations as they are essential and considered part of the Medicare Integrity Program. Thus,…
Medicare Secondary Payer operations will not be affected as they are essential and considered part of the Medicare Integrity Program. However, were are receiving word…
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)…
The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 non-group health plan (NGHP) User Guide (Version 5.3, December 15, 2017).
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…
On October 26, 2017, the Centers for Medicare and Medicaid Services (CMS) has released its latest update regarding the LMSA issue.
The Centers for Medicare and Medicaid Services (CMS) awarded Performant Financial Corporation (Performant) the Commercial Repayment Center (CRC) contract.
The recent passage of Arizona Senate Bill (S.B.) 1332 provides Arizona claims payers with unprecedented opportunity to close out their workers' comp claims.
A new case out of Connecticut highlights complications insurers can encounter in obtaining information to assess their MSP compliance obligations.
Section 111 reporting used to be viewed as an abstract technical Medicare compliance obligation & IT's responsibility because of the data transmission.
Your Section 111 reporting program may seem clear-cut, but it can mean risky business if your team isn’t prepared to avoid common compliance mistakes.
When challenging Medicare conditional payment claims, parties must exhaust Medicare administrative appeals before filing an action in federal court.