Category Archives: Blog

Blog, Legal/Legislative News, Medicare Jurisdiction, Trial Practice

Franco Signor has been following the CIGA (California Insurance Guaranty Association) litigation filed against HHS/CMS for some time. CIGA is California’s largest workers’ compensation provider as the insurer of last resort for employers where the employer/insurer is insolvent and unable to pay claims. Last we blogged about the case in 2017, the litigation was entitled CIGA v. Price, and the …
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Blog, Medicare Advantage Part C

Recall last year in 2018 we blogged that Humana Medicare Advantage had filed an action against Bi-Lo, LLC, a grocery retailer, in the U.S. District Court for the District of South Carolina for declaratory relief and monetary damages to recover amounts allegedly due and owing to Humana Medicare Advantage Organization (MAO) for payments made on behalf of Enrollee (the Medicare …
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Blog, Franco Signor News, Medicare Set Aside, WCMSA

PLOTTING A COMPLIANCE COURSE What to Consider When Determining Whether or Not to Submit an MSA to CMS By: Heather Sanderson and Claire Muselman For Workers Compensation Medicare Set-Asides (WCMSA), there is no requirement that they be submitted to the Centers for Medicare & Medicaid Services (CMS) for approval, although it is common for settling parties to do so. What …
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Franco Signor Medicare Blog Receives Prestigious Honor

05 Sep 2019 Jesse Hamby No Comments

About Franco Signor, Blog, Franco Signor News

Once again in 2019, Franco Signor’s Medicare Secondary Payer Compliance Blog has been chosen by Workerscompensation.com as one of the best blogs in the workers’ compensation industry. We want to thank all of you who took the time to nominate us. In addition, we want to thank the thousands of Franco Signor blog readers visiting our site each month. Franco Signor Chief Legal Officer …
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Blog, Legal/Legislative News, Medicare Set Aside, WCMSA

We have blogged on numerous occasions regarding Workers’ Compensation Medicare Set-Aside (WCMSA) legislation that continues to be re-introduced in Congress with slight variations over the last decade (hereinafter referred to as “WCMSA Bill”). Our 2018 blog on the prior WCMSA Bill can be found here. The current 2019 proposed WCMSA Bill can be found here. This year, the WCMSA Bill …
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Blog, Medicare Conditional Payments

On August 9, 2019, the Commercial Repayment Center (CRC) held an industry conference call and announced it was under mandate to reduce the current backlog of 338,819 conditional payment leads.  Instead of inundating the industry with hundreds of thousands of Conditional Payment Notices (CPNs), the CRC plans to ask Responsible Reporting Entities (RREs) to update their Section 111 data.  By …
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Blog, Legal/Legislative News, Medicare Jurisdiction

CMS recently updated the unified agenda with regard to proposed rulemaking for guidance regarding how beneficiaries were to protect Medicare’s interest in workers’ compensation, liability and no-fault settlements.  The amended announcement now pushes publication of any rule from September 2019 to October 2019.  Another change made was to eliminate all references to line of business and the term “guidance”.  Rather, …
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Blog, Legal/Legislative News, Medicare Advantage Part C

The Wild Wild West of Medicare Advantage Organizations (MAOs) filing litigation nationwide against primary plans (workers’ compensation, liability or no-fault carriers/plans) to establish the right to a Medicare Secondary Payer (MSP) private cause of action for failure to reimburse the MAO for unreimbursed conditional payments continues. As of our last update, both the 3rd Circuit (encompassing New Jersey, Delaware and …
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Blog, Medicare Conditional Payments

As a continuing effort to update our readers on the Commercial Repayment Center (CRC), we are providing an update on the CRC’s recovery activities. Franco Signor has been notified that several large insurance carriers have received preliminary notice of a large number of potential debts that the CRC intends to issue Conditional Payment Notices (CPNs) or Demands on. Recall that …
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CMS Updates NGHP User Guide with Minor Changes

08 Jul 2019 Heather Sanderson No Comments

Blog, Legal/Legislative News, Medicare Secondary Payer News

As of July 1, 2019, CMS updated its NGHP User Guide to Version 5.6 with Minor Changes. A list of the changes made in the new Guide can be found here. Additionally, the updated Guide can be found at https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Mandatory-Insurer-Reporting-For-Non-Group-Health-Plans/NGHP-User-Guide/NGHP-User-Guide.html. Contact us with any questions at engage@francosignor.com.

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