Blog, LMSA, Medicare Secondary Payer News, Medicare Set Aside, WCMSA

Liability Medicare Set-Asides (LMSAs) and No-Fault Medicare Set-Asides (NFMSAs) Update – The Centers for Medicare and Medicaid Services (CMS) has been taking incremental steps recently to implement a review process for LMSAs and NFMSAs. Over the past year we saw a series of indications that CMS was looking to implement a review process.  The Request for Proposal (RFP) for the Workers’ Compensation …
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Blog, Legal/Legislative News, Medicare Advantage Part C

Hartford Casualty Insurance Company is the target of a new complaint recently filed in the United States District Court, Western District of Washington (Seattle) by Humana Health Plan. Humana, as a Medicare Advantage Plan (MAP) is seeking a declaratory judgment as to Hartford’s obligation to reimburse conditional payments made by Humana, as well as a private cause of action pursuant …
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Blog, Medicare Set Aside, WCMSA

Back in November of 2016, we blogged regarding the Workers’ Compensation Review Contractor (WCRC) introducing more stringent requirements for CMS approval of a zero Workers’ Compensation Medicare Set-Aside (WCMSA). For a short period of time, the WCRC was requiring either a court order or treating physician statement to approve a zero MSA allocation. However, the WCRC retracted this policy just …
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A Message of Thanks from Franco Signor

15 Sep 2017 Jesse Hamby No Comments

About Franco Signor, Franco Signor News

As Franco Signor returns to full capacity after Hurricane Irma, we want to take this opportunity to thank all of you for the well wishes and messages of concern.  Our home state of Florida was heavily impacted by the storm.  And while this has been an incredibly stressful week for residents of this great state, it was tremendously encouraging to see …
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Blog, Legal/Legislative News, Medicare Advantage Part C

Over the past several years, we have witnessed Medicare Advantage Plans (MAPs) flex their muscles in establishing their rights to recover double damages through a Medicare Secondary Payer (MSP) private cause of action for double damages against “primary plans” (workers’ compensation, liability, and no-fault insurance carriers/self-insured entities) for failure to timely reimburse MAP conditional payments. Well known and important decisions …
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