Category Archives: Trial Practice

Blog, Medicare Advantage Part C, Trial Practice

We have blogged  about Medicare Advantage Plans (MAPs) and MSP Recovery LLC for quite some time now, but a recent industry blog (“Illinois Court Indicates MAPs Have “Double Damages” Rights”) requires us to also clarify the ruling of this new court decision to avoid  confusion for our Illinois clients about Illinois MAP recovery rights in that state.  To clarify that …

Blog, Franco Signor News, Trial Practice

Title Franco Signor Presents: Settling a claim involving a Medicare beneficiary? Best Practices Must Be Utilized. Description EXPOSURES ARE REAL Upon settlement of a workers’ compensation, liability, or no-fault claim, parties involved must consider both past and future medical expenses. However, reaching a settlement can be challenging when the claimant, the claimant’s attorney, and the carrier want to control the …

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

Medicare Advantage Plans have set their sights on a new target for the MSP Private Cause of Action: Plaintiff attorneys representing Medicare beneficiaries. We have previously only seen these causes of action against insurance companies, self-insureds and providers. In an opinion out of the U.S. District Court for the Eastern District of Virginia, Humana v. Paris Blank LLP, 2016 U.S. …

Blog, Legal/Legislative News, Medicare Jurisdiction, Medicare Secondary Payer News, Trial Practice

In an opinion out of the U.S. District Court for the Middle District of Pennsylvania, Mikiewicz v. Hamorski and Erie Insurance Exchange, 2016 U.S. Dist. LEXIS 58859 (May 3, 2016), the Defendant Erie Insurance Exchange (“Erie”) removed the Plaintiff Helen Mikiewicz’s (“Plaintiff”) auto accident litigation to Federal Court. Erie had initiated removal to Federal Court due to the fact that …

Blog, Legal/Legislative News, Medicaid Third Party Liability Recoveries, Medicare Jurisdiction, Medicare Secondary Payer News, Trial Practice

In an unpublished opinion out of Illinois, McKim v. Southern Illinois Hospital Services, the issue litigated was whether certain government benefit program liens (e.g., Medicare and Medicaid) were capped by state lien law. As expected, the court disagreed, finding that Federal preemption entitled governmental plans like Medicare, Medicaid and Part D to not be subject to limitations imposed by state …

Blog, Medicare Conditional Payments, MSPRC Appeals, Trial Practice

Anderson v. Burwell, 2016 U.S. Dist. LEXIS 26633 (March 3, 2016), arises out of the United States District Court for the Eastern District of Michigan, Southern Division.  It raises many interesting Medicare Secondary Payer (MSP) conditional payment reimbursement issues. The background of the case essentially involves a Plaintiff, Roland Anderson, Jr. (“Plaintiff”) who was the personal representative of the estate …

Blog, Legal/Legislative News, Medicare Secondary Payer News, Trial Practice

The False Claims Act’s (FCA) purpose is to deter fraud upon the U.S. government, and whistle-blowers are incentivized to bring such actions due to the potential to recover triple damages against the fraudulent entity. With regard to Medicare Secondary Payer (MSP) FCA litigation, we have really only seen two whistleblowers try to bring MSP FCA actions up until now, United …

Blog, Medicare Jurisdiction, Trial Practice

A recent Michigan state court ruling involving the Medicare Secondary Payer (MSP) Act has broad applications for the administration of worker’s compensation matters across the country.   If this decision stands, then liability for Medicare conditional payments is immediate once identified and it does not matter if the underlying filing is properly denied by the Employer. Typical reasons for denial by …

Takemoto False Claims Act Case Closed

21 Jan 2016 Heather Sanderson No Comments

Blog, Legal/Legislative News, Medicare Jurisdiction, Trial Practice

Earlier last year we blogged about this MSP False Claims Act case being recommended to be dismissed with prejudice by Magistrate Judge McCarthy. For our prior blog and further background on this case, please click here. Yesterday, United States District Judge William Skretny issued a decision and order denying Takemoto’s request to re-plead his case and objections to Judge McCarthy’s decisions. …

Blog, Medicare Advantage Part C, Medicare Jurisdiction, Trial Practice

Infuse bone graft is FDA approved for certain spinal fusion procedures.  In 2002, Humana agreed to reimburse their insureds for off-label use in reliance on Medtronics’ medical literature that touted the benefits of the infuse product while underreporting its adverse effects.  Humana reversed this policy in February 2009 based on medical literature that questioned the safety and efficacy of Infuse …

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