Blog, Medicare Secondary Payer News, MSPRC Appeals

On Monday, Congressman Tim Murphy for Pennsylvania and Congressman Ron Kind for Wisconsin introduced H.R. #1063 to bring needed improvements to the Medicare Secondary Payer Act.  Long overdue, the proposed legislation builds on the coalition’s previous effort last year when it launched H.R. #4796.  That legislation died last year when the 111th Congressional Session ended on December 31, 2010. H.R. …
READ MORE

Blog, Trial Practice

Many times our Company is asked whether or not it is appropriate for a lawyer to sign a release agreement that includes an indemnification clause by the lawyer or law firm.  The issue has come up more frequently as primary plans (insurance carriers and self insureds) attempt to navigate their contingent liabilities created by the Medicare Secondary Payer Act.  Prevailing thought is that if the …
READ MORE

Blog, Medicare Advantage Part C, Medicare Conditional Payments, Medicare Jurisdiction

Before today, it was unclear what rights, if any, a Medicare Advantage Plan had under the Medicare Secondary Payer Act. Most felt that recovery rights of a Medicare Advantage Plan were the same as traditional Medicare under Parts A & B. That’s because 42 C.F.R. §422.108 granted Medicare Advantage Plans the same rights as the Secretary which was thought to …
READ MORE

Blog, LMSA, Medicare Set Aside

It was bound to happen.  When legal responsibility exists to comply with a law, but no policy or procedure is in effect as to how, parties to a liability case will fashion their own solution.  That’s exactly what took place in Big R Towing, Inc. v. David Wayne Benoit, et al,  2011 U.S. Dist. LEXIS 1392 where the court was …
READ MORE

Ninth Circuit Disagrees with Bradley v. Sebelius

05 Jan 2011 Roy Franco No Comments

Blog, Medicare Conditional Payments, Reimbursements

Recently, the Nevada Federal District Court in Farmers Insurance Exchange v. Leona Forkey 2010 U.S. Dist. LEXIS 137716 upheld the Ninth Circuit’s position in Zinman v. Shalala, 67 F.3d 841 (9th Cir. 1995) that Medicare’s reimbursement claim for conditional payments takes precedence over the claims of any other party.  Citing the Medicare Secondary Payer Manual as authority for its position, …
READ MORE

Blog, Medicare Conditional Payments, Reimbursements

By Jeff Signor & Roy Franco Surprised? We are not. To alleviate the contingent liabilities created by the Medicare Secondary Payer Act (MSPA) parties must cooperate. Without cooperation on the Medicare topic, there will be more decisions like Zaleppa v. Seiwell, 2010 PA Super 208 (11/17/2010). The MSPA is designed to protect the Medicare beneficiary. Therefore, primary plans cannot deprive …
READ MORE

© 2012-2017 Franco Signor LLC