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CLM Magazine Article: Clock Nears Midnight for Civil Monetary Penalties

Aug 6, 2020

The original article was printed in the August issue of CLM Magazine. It was written by Heather Sanderson and Kimberly Vaughn. The industry has speculated for years whether and when the Centers for Medicare & Medicaid Services (CMS) would seek to enforce civil...

Plaintiffs’ Release of All Claims Not Enough to Protect Defendant Carrier Against a Double Damages Cause of Action under the MSP Six Years Post-Settlement

Jul 7, 2020

In an opinion out of the United States District Court for the District of New Jersey, Osterbye v. United States, 2020 U.S. Dist. LEXIS 116591 (June 30, 2020), the Court denied Defendant Selective Insurance’s (Defendant) Motion to Dismiss Plaintiff’s suit and...

What Entities Can Avail Themselves of the MSP Private Cause of Action for Double Damages? United States Weighs in on this Question in the Eleventh Circuit Court of Appeals

Jun 22, 2020

Just recently, the United States Department of Health & Human Services (HHS) submitted an Amicus Curiae Brief in the Eleventh Circuit in the MSP Recovery Claims, LLC v. Ace American Insurance Company, et al case. A copy of the Amicus Brief can be found here. For...

Rhode Island District Court Places Responsible Primary Payer Between a Rock and MSP

Apr 29, 2020

A recent decision out of Rhode Island demonstrates a common dilemma wherein a Non-Group Health Plan (workers’ compensation, liability, or no-fault insurance carrier or self-insured) Responsible Reporting Entity (RRE) is stuck between a rock and a hard place (Medicare...

Texas Personal Injury Law Firm Sued by U.S. Attorney’s Office Highlights Medicare’s Position of Demanding Full Reimbursement of Conditional Payments

Apr 1, 2020

A lawsuit filed in in the United States District Court for the Southern District of Texas by the U.S. alleges that the plaintiff attorney in a personal injury action (Carrigan & Anderson, PLLC and Attorney Stephen P. Carrigan individually) failed to reimburse...

Ninth Circuit Concludes Judgment in Favor of CIGA as a Guaranty Fund Not Subject to MSP Obligations

Mar 9, 2020

As we had blogged about last October, the 9th Circuit in CIGA v. Azar held that CIGA as a Guaranty Fund was not a “primary plan” under the MSP, due to the fact that CIGA pays for medical care only if the insurer is insolvent, and as such the WC claim does not...
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Recent Posts

  • Medicare Updates: CMS NGHP Beneficiary Recovery Webinar & Medicare conditional payment “round-up”
  • CMS releases updated Medicare Secondary Payer Recovery Portal (MSPRP) user guide (Version 5.0) – updated functionality made to the claims listing interface
  • CMS Releases New WCMSA Reference Guide (Version 3.2)
  • CMS releases new NGHP Section 111 User Guide (Version 6.0) and updated accepted/excluded ICD code listings
  • CMS discusses conditional payment appeal issues on its NGHP Applicable Plans webinar

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