Category Archives: Medicare Advantage Part C

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

The U.S. District Court for the Southern District of Texas has issued an opinion in ongoing litigation by Aetna and Humana, both Medicare Advantage Plans (MAPs), against a Plaintiff law firm that represented asbestos trusts. The allegation by Aetna and Humana (“Plaintiffs”) is that Defendant Shrader Associates LLP (“Schrader”) represented at least fifteen “Matched claimants” that received coverage from the …
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Blog, Legal/Legislative News, Medicare Advantage Part C

Primary Plans Beware: The tide continues to turn across the country in favor of Medicare Advantage Plans (MAPs) having a right to sue primary plans based on the Medicare Secondary Payer (MSP) private cause of action and the ability to seek double damages for the failure to reimburse MAP conditional payments. The decision has the potential to extend the law …
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Blog, Medicare Advantage Part C

Recall that in September 2016, the Eleventh Circuit Court of Appeals ruled that Humana Medicare Advantage may sue a primary plan for failure to reimburse conditional payments under the Medicare Secondary Payer (MSP) private cause of action for double damages. The Eleventh Circuit encompasses the jurisdictions of Florida, Alabama, and Georgia. For our original blog on the Eleventh Circuit Western …
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