VISUALIZE | INSIGHTS THAT POWER INNOVATION

Medicare Secondary Payer (MSP)

Joshua Coleman Vf7v9mwonlk Unsplash
August 14, 2018

Drug formularies continue to expand in workers’ comp systems

Balancing rising medical and pharmaceutical costs with appropriate and timely treatment for injured workers has been an ongoing struggle for workers’ compensation…

Glenn Carstens Peters Npxxwgq33zq Unsplash
July 12, 2018

Minor changes in newly released Medicare Secondary Payer Recovery Portal User Guide

The Centers for Medicare and Medicaid Services (CMS) has released an updated version of its Medicare Secondary Payer Recovery Portal (MSPRP) User Guide (Version 4.2). The…

Jp Valery Lvfoii3sjq8 Unsplash
June 20, 2018

Law firm reaches settlement with U.S. Department of Justice to reimburse Medicare conditional payments and start internal MSP compliance program

The United States Department of Justice (DOJ) for the Eastern District of Pennsylvania has issued a news release reporting that a Philadelphia personal injury law firm…

Court
June 8, 2018

Court denies “double damages” under the MSP’s private cause of action

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…

Hanson Lu Sq5p00l7lxc Unsplash
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 Medicare Advantage Plans (MAPs) have private cause of action (PCA) rights to pursue “double damages” under the…

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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: Medicare Secondary Payer (MSP) compliance will continue to present formidable challenges for claims…

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January 23, 2018

Government shutdown ends – Congress and President reach deal

This brief government shutdown did not affect Medicare Secondary Payer operations as they are essential and considered part of the Medicare Integrity Program. Thus,…

Andy Feliciotti 8cvji48sfty Unsplash
January 22, 2018

Government shutdown & Medicare Secondary Payer impact

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…

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)…

Anastasia Zhenina Dzqkdffa00c Unsplash
December 21, 2017

CMS Releases New Section 111 NGHP User Guide (Version 5.3)

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). This…

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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…

Files
October 26, 2017

Liability MSA update

On October 26, 2017, the Centers for Medicare and Medicaid Services (CMS) has released its latest update regarding the LMSA issue.

Folders
October 6, 2017

Performant awarded CMS Commercial Repayment Center contract

The Centers for Medicare and Medicaid Services (CMS) awarded Performant Financial Corporation (Performant) the Commercial Repayment Center (CRC) contract.

Antoine Dautry Zsl306fdck Unsplash
September 26, 2017

Countdown to “full and final” settlements: Arizona S.B. 1332

The recent passage of Arizona Senate Bill (S.B.) 1332 provides Arizona claims payers with unprecedented opportunity to close out their workers' comp claims.

Kelly Sikkema 1055176 Unsplash
June 16, 2017

Court blocks Medicare discovery requests - Ruling limits insurer's ability to determine MMSEA obligations

A new case out of Connecticut highlights complications insurers can encounter in obtaining information to assess their MSP compliance obligations.