Category Archives: Trial Practice

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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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, 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, 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 …
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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 …
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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. …
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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 …
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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 …
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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 …
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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 …
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