Blog, Legal/Legislative News, Medicare Conditional Payments

A new decision by the U.S. District Court for the Middle District of Pennsylvania, entitled United States v. Angino, 2019 U.S. Dist. LEXIS 30499 (February 26, 2019), which involves the United States filing a lawsuit to recover conditional payments from the plaintiff attorney, Medicare beneficiary, and “primary plan” caught our attention.  The lawsuit reignites the debate on whether the parties …
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Blog, Legal/Legislative News, Medicare Jurisdiction, Medicare Reporting Section 111, Medicare Secondary Payer News

The Medicare Advocacy Recovery Coalition (MARC) has announced that the Provide Accurate Information Directly (PAID) Act was introduced yesterday, February 27, 2019 in the U.S. House of Representatives as H.R. 1375 by lead Co-Sponsors Reps. Ron Kind (D-WI) and Gus Bilirakis (R-FL). Representatives Kind and Bilirakis have sponsored this bipartisan legislation to improve the Medicare Secondary Payer Act (MSP). PAID’s …
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Blog, Legal/Legislative News, Medicaid Third Party Liability Recoveries, Medicare Secondary Payer News

The following article was co-written by: Roy Franco, Chief Client Officer and Matthew Newman, Associate Compliance Counsel A U.S. District Court’s ruling regarding MSP Recovery LLC’s recent filings in State Court has raised concerns about a possible Medicaid Third Party Liability recovery strategy.  The situation involves an archaic discovery mechanism (“bill of pure discovery”) that would allow MSP Recovery LLC …
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Blog, Legal/Legislative News, Medicare Advantage Part C, Medicare Conditional Payments

The Non-Group Health Plan (NGHP) industry is not only experiencing increased recovery demands from Medicare Advantage Plans (MAPs) as of recently, but are also experiencing MAPs attempting to assert a greater right of recovery for conditional payments than traditional Medicare would have available. As a foundational matter, there are certain parameters laid out in the Medicare Secondary Payer Act (MSP) …
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CMS Updates WCMSA Reference Guide and NGHP User Guide

09 Jan 2019 Heather Sanderson No Comments

Blog, Medicare Set Aside, WCMSA

Yet another indication that The Centers for Medicare & Medicaid Services (CMS) intends to make Medicare Secondary Payer (MSP) enforcement a priority in 2019: both the WCMSA Reference Guide and NGHP User Guide have been updated with several impactful changes. The updated WCMSA Reference Guide can be found here, and the updated NGHP User Guide can be found here. WCMSA …
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Blog, Medicare Reporting Section 111, Medicare Secondary Payer News, RRE

The Centers for Medicare & Medicaid Services (CMS) has issued yet another abundantly clear signal that Medicare Secondary Payer (MSP) enforcement will be a priority in 2019. Just last week, we blogged that a Proposed Rule on a voluntary review process for Liability Medicare Set-Asides (LMSAs) would be issued by September 2019. Now, an additional notice on the Office of Management and …
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