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...
Nov 5, 2019
Insurance Companies and Self-Insureds that process claims for workers’ compensation, liability and no-fault claims (Primary Plans) involving Medicare beneficiary claimants need a better way to obtain information about Medicare Advantage and Part D Drug Plans that may...
Jun 5, 2019
Several of our clients have been experiencing an increase in conditional payment letters from Medicare Part D prescription drug plans. Historically, Part D plans have been less active in recovery of conditional payments than traditional Medicare or Medicare Advantage...
Nov 13, 2018
What is the intended purpose behind a Workers’ Compensation Medicare Set-Aside (WCMSA)? The WCMSA Reference Guide, Section 3.0 states: “A WCMSA allocates a portion of the WC settlement for all future work-injury-related medical expenses that are covered and otherwise...
Oct 18, 2018
Recently, CMS updated its Part D Manual to include specific changes to the Manual’s Medicare Secondary Payer (MSP) provisions. The updated manual can be found here. Page 40 now provides: “Part D sponsors are responsible for adjudicating enrollees’ claims in...
Mar 29, 2018
A new decision was handed down from the U.S. Court of Appeals for the 11th Circuit in the Barbara J. Harvey v. Florida Health Sciences Center, Inc. this month. Here, the Plaintiff pursued a medical malpractice claim against a hospital for her husband’s death. The...
