Settlement Contingent Upon CMS Approval of WCMSA: Problematic?

A decision just issued out of the Third Circuit Court of Appeal in Louisiana demonstrates the various nuances and obstacles that may be present when entering into a workers’ compensation settlement contingent upon CMS approval of a WCMSA. In Ortega v. Cantu Servs.,...

MSP Medicare Advantage Plan Recovery Rights Case Law Rampant

The Medicare Advantage Plan (MAP) system continues to grow; according to the Kaiser Family Foundation, as much as 31% of the Medicare population in the United States is also enrolled in a Medicare Advantage Plan. Recently, we have seen a great deal of case law where...

State Appellate Court Reinstates Plaintiff’s MSP Private Cause of Action Against No-Fault Insurer – “Demonstrated Responsibility” can be Established Without a Settlement, Judgment, or Award based on Insurance Contract

We recently posted a blog regarding CMS’ May 5th webinar wherein CMS expressed their intent to recover conditional payments in Ongoing Responsibility for Medical (ORM) cases. This statement during CMS’ webinar was somewhat of a surprise, as CMS’ recovery contractor...

Medicare Advantage Plans MSP Private Cause of Action Gains Momentum

The 31 page written decision by U.S. Federal District Court Judge Eldon Fallon advances Medicare Advantage Organizations (MAOs) on a number of fronts.  This 5th Circuit opinion in Amie Collins v. Wellcare Plans, Inc. from the Eastern District of Louisiana makes a...