23 Jul 2018 Heather Sanderson No Comments
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 …
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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 …
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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 …
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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 …
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22 May 2018 Heather Sanderson No Comments
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 …
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02 May 2018 Heather Sanderson No Comments
Blog, Medicare Conditional Payments
On April 18, 2018, New Jersey Director & Chief Judge of Compensation Russell Wojtenko, Jr. issued a memorandum to all NJ Judges of Compensation, Bar Members, and Court Staff entitled “Medicare Conditional Payments.” In addition to providing background of the requirements of the Medicare Secondary Payer (MSP) Act, the memorandum provides guidance on how parties must report via Section 111 MMSEA Reporting …
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19 Apr 2018 Heather Sanderson No Comments
Blog, Medicare Advantage Part C, Medicare Conditional Payments, Medicare Secondary Payer News, Trial Practice
As we have noted in numerous recent blogs, Medicare Secondary Payer (MSP) Private Cause of Action litigation has been on the rise and has grown to be incredibly rampant in the past several years. Innate to this recently popular weapon for double damages against primary plans is the unfortunately vague and ambiguous language in the MSP defining the action. The …
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03 Apr 2018 Heather Sanderson No Comments
About Franco Signor, Blog, Medicare Advantage Part C
On April 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare Advantage Plan (MAP) and Medicare Part D policy changes which provides the plans “with new tools to improve quality of care and provide more plan choices for MA and Part D enrollees.” CMS estimates that the changes will result in $295 …
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29 Mar 2018 Roy Franco No Comments
Blog, Medicare Advantage Part C, Pharma Part D, Trial Practice
A new decision was handed down from the U.S. Court of Appeals for the 11th Circuit in the Barbara J. Harvey v. Florida Health Sciences Center, Inc. this month. Here, the Plaintiff pursued a medical malpractice claim against a hospital for her husband’s death. The hospital agreed to binding arbitration on the sole issue of damages to avoid a lawsuit. …
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28 Mar 2018 Roy Franco No Comments
Blog, Medicare Advantage Part C, Pharma Part D
The Medicare Advocacy Recovery Coalition (MARC) is an organization made up of insurance companies, third party administrators, defense firms, plaintiff firms and MSP compliance companies. MARC recently announced an important new legislative initiative. Primary Plans which are plagued unfairly by MSP private cause of action claims would have an important tool at their disposal, once the legislation is introduced and …
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