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New Jersey Court Grants Motion to Enforce & Questions Need for Liability Medicare Set Asides

Aug 17, 2012

Sipler v. Trans Am Trucking, Inc., et al., 2012 US Dist. LEXIS 109278 (U.S. Dist. Court for New Jersey, 7/24/2012). Facts: (Highlights): A settlement was reached for $225,000 on the eve of trial; No other terms were discussed at the time of settlement The injured...

Third Circuit Court of Appeals Expands MSP Private Cause of Action to Medicare Advantage & Part D (Prescription) Private Insurance Plans

Jul 2, 2012

Overview Humana, a Medicare Advantage Plan, used the Medicare Secondary Payer Private Cause of Action (42 U.S.C. Section 1395y(b)(3)(A) to bring suit against a self insured primary plan.  The lawsuit was brought in Federal Court to recover damages for the failure of...

Does Medicare’s Reimbursement Claim Take Priority over Non-Medicare Beneficiaries Damages in a Common Fund Situation?

Oct 20, 2010

Does Medicare’s Reimbursement Claim Take Priority over Non-Medicare Beneficiaries Damages in a Common Fund Situation?  No.  In a recent decision by the 11th Circuit, an allocation order by a state court of a common settlement fund between Medicare beneficiaries and...

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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