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CMS Maintains Thresholds for Workers’ Compensation, Liability and No-Fault Settlements at $750 for 2019; MSPRP Improvements Webinar to be Hosted by CMS

Nov 20, 2018

As required by section 202 of The SMART Act, CMS is required to annually review its costs relating to recovering conditional payments as compared to recovery amounts. For the last two years 2017-2018, CMS has maintained the threshold of $750 across all non-group...

MSP Recovery’s Ocean Harbor Class Certification Attempt Backfires: 3rd Circuit Court Declines to Certify Class of Florida Medicare Advantage Plans

Sep 27, 2018

Recall MSP Recovery LLC, a law firm out of Miami, Florida that has been initiating numerous class action litigation country-wide as assignees on behalf of Medicare Advantage Plans (MAPs) alleging that various primary payers have failed to reimburse MAP conditional...

Franco Signor Thanks Congressmen Bilirakis and Kind for Introduction of the PAID Act

May 22, 2018

We have previously blogged about the PAID Act- legislation promulgated by the Medicare Advocacy Recovery Coalition (MARC) which, if passed, would enable Responsible Reporting Entities (RREs) to have insight into Medicare Advantage Plan, Medicare Part D, and Medicaid...

The Multi-Level Medicare Conditional Payment Appeals Process Proves to be Useful for Primary Plans

Jan 8, 2018

Prior to 2013, insurance carriers did not have the same appeal rights as beneficiaries and if Medicare made an incorrect determination as to a primary plan’s responsibility for conditional payments, the primary plan was stuck with the responsibility to pay and without...

Florida District Court: Beneficiaries Should Not Rely upon Estimated Conditional Payment Amounts

Mar 27, 2017

In a decision out of the Southern District of Florida, Shapiro v. Secretary of HHS, 2017 U.S. Dist. LEXIS 42278 (March 23, 2017), the District Court affirmed a final decision of the Medicare Appeals Council (“MAC”) rejecting a Medicare beneficiary’s...
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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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