Blog, Legal/Legislative News, Medicare Advantage Part C, Medicare Jurisdiction, Medicare Secondary Payer News

Reprinted from the Morning Consultant In health policy, the minutia is not trivial; it’s essential. Small incentives created by policymakers can have a significant impact upon how Medicare beneficiaries, doctors, hospitals and insurers respond to health care claims. But sometimes policies — even the most well-intentioned — can have unintended consequences, leading to wasted resources, burdensome regulations and broken promises …
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Blog, Medicare Reporting Section 111, ORM

In our oversight of numerous MMSEA Section 111 programs nationwide, we frequently answer many questions from clients surrounding Ongoing Responsibility for Medical (ORM). The confusion is understandable as ORM can be complicated. Let’s explore the various types of questions that we most often receive: What constitutes ORM? CMS defines ORM as a Responsible Reporting Entity (RRE)’s responsibility to pay for …
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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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Administration, Blog, Legal/Legislative News, Medicare Set Aside, WCMSA

For numerous years, a slightly varied version of essentially the same proposed legislation regarding Workers’ Compensation Medicare Set-Asides (WCMSAs) continues to be re-introduced in Congress (hereinafter referred to as “MSA Bill”). Just last week, the MSA Bill was again introduced in the Senate. It is titled “Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act of 2018.” A copy of …
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Blog, Medicare Conditional Payments, Trial Practice

A press release has been issued by the U.S. Attorney’s Office for the Eastern District of Pennsylvania announcing that U.S. Attorney William McSwain has entered into a settlement with a Philadelphia personal injury law firm, Rosenbaum & Associates, and its principal, Jeffrey Rosenbaum, Esq. to resolve allegations that they failed to reimburse the United States for certain Medicare payments the government …
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About Franco Signor, Franco Signor News

As we announced last month, Franco Signor’s Chief Legal Officer, Heather Sanderson, was chosen by Business Insurance magazine as one of the winners of their 2018 Breakout Awards. The awards program, which was introduced last year, recognizes the next generation of insurance industry leaders. Nominations are open to anyone working in the commercial insurance and risk management sector. Click here to see the 2018 list …
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