Category Archives: Blog

Blog, Legal/Legislative News, Medicare Advantage Part C, Medicare Jurisdiction, Medicare Secondary Payer News

Reprinted from the Morning Consultant In health policy, the minutia is not trivial; it’s essential. Small incentives created by policymakers can have a significant impact upon how Medicare beneficiaries, doctors, hospitals and insurers respond to health care claims. But sometimes policies — even the most well-intentioned — can have unintended consequences, leading to wasted resources, burdensome regulations and broken promises …
READ MORE

Blog, Medicare Reporting Section 111, ORM

In our oversight of numerous MMSEA Section 111 programs nationwide, we frequently answer many questions from clients surrounding Ongoing Responsibility for Medical (ORM). The confusion is understandable as ORM can be complicated. Let’s explore the various types of questions that we most often receive: What constitutes ORM? CMS defines ORM as a Responsible Reporting Entity (RRE)’s responsibility to pay for …
READ MORE

Blog, Legal/Legislative News, Medicare Advantage Part C, Medicare Conditional Payments

Earlier this year, we blogged about an action by MSP Recovery LLC against State Farm being dismissed. Recall that MSP Recovery LLC is an entity out of Miami, Florida that has been filing litigation and class actions nationwide on behalf of Medicare Advantage Plans (MAPs) against primary plans for the alleged failure to reimburse conditional payments to the MAP. For …
READ MORE

Administration, Blog, Legal/Legislative News, Medicare Set Aside, WCMSA

For numerous years, a slightly varied version of essentially the same proposed legislation regarding Workers’ Compensation Medicare Set-Asides (WCMSAs) continues to be re-introduced in Congress (hereinafter referred to as “MSA Bill”). Just last week, the MSA Bill was again introduced in the Senate. It is titled “Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act of 2018.” A copy of …
READ MORE

Blog, Medicare Conditional Payments, Trial Practice

A press release has been issued by the U.S. Attorney’s Office for the Eastern District of Pennsylvania announcing that U.S. Attorney William McSwain has entered into a settlement with a Philadelphia personal injury law firm, Rosenbaum & Associates, and its principal, Jeffrey Rosenbaum, Esq. to resolve allegations that they failed to reimburse the United States for certain Medicare payments the government …
READ MORE

MSP Recovery LLC and its Attorneys Sanctioned

12 Jun 2018 Heather Sanderson No Comments

Blog, Legal/Legislative News, Medicare Advantage Part C, Trial Practice

If you follow our blog, you will recall an entity called MSP Recovery LLC, a law firm in Miami, Florida which alleges to have received assignments on behalf of various Medicare Advantage Plans (MAPs) to pursue double damages Medicare Secondary Payer (MSP) private cause of action lawsuits and class actions nationwide. The allegation by MSP Recovery in these lawsuits are …
READ MORE

About Franco Signor, Blog, Medicaid Third Party Liability Recoveries, Medicare Secondary Payer News

Originally published in the June 2018 Issue of CLM Magazine TIME TO GET PAID In 1965, President Johnson signed into law the Medicaid program, establishing the state-based healthcare safety net system in place today. Although since that time Congress has undertaken dozens of efforts to streamline and improve Medicaid, historically there has not been considerable focus to improve states’ Medicaid …
READ MORE

About Franco Signor, Blog, Franco Signor News

Once again in 2018, Franco Signor’s Medicare Secondary Payer compliance blog has been chosen by workerscompensation.com as one of the best blogs in the workers’ compensation industry. We want to thank all of you who took the time to nominate us. In addition, we want to thank the thousands of Franco Signor blog readers visiting our site each month. Franco …
READ MORE

Blog, Legal/Legislative News, Medicare Advantage Part C

We have previously blogged about the PAID Act- legislation promulgated by the Medicare Advocacy Recovery Coalition (MARC) which, if passed, would enable Responsible Reporting Entities (RREs) to have insight into Medicare Advantage Plan, Medicare Part D, and Medicaid enrollment information. This data would be provided in the query response file via MMSEA Section 111 Reporting. Franco Signor is proud to be a founding …
READ MORE

Settlement Contingent Upon CMS Approval of WCMSA: Problematic?

08 May 2018 Heather Sanderson No Comments

Blog, Legal/Legislative News, Medicare Secondary Payer News, WCMSA

A decision just issued out of the Third Circuit Court of Appeal in Louisiana demonstrates the various nuances and obstacles that may be present when entering into a workers’ compensation settlement contingent upon CMS approval of a WCMSA. In Ortega v. Cantu Servs., Inc. 2018 La. App. LEXIS 845 (May 2, 2018), the claimant, a Medicare beneficiary, settled her disputed …
READ MORE

© 2012-2017 Franco Signor LLC