Category Archives: Medicare Jurisdiction

Blog, Legal/Legislative News, Medicare Jurisdiction, Medicare Secondary Payer News

During an interview on this past Sunday, President Trump indicated that he does not plan to touch the concept of Medicare; however, he and his administration would be tough on Medicare fraud, waste, and abuse. The timing of this statement by President Trump is coincidental with the United States joining in on a False Claims Act (FCA) whistleblower lawsuit this …
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Blog, Legal/Legislative News, Medicaid Third Party Liability Recoveries, Medicare Jurisdiction, Medicare Secondary Payer News, Medicare Set Aside

A Complaint has been filed in the State of Utah by its Attorney General to force four of its largest asbestos bankruptcy trusts to comply with civil investigative demands (CIDs) seeking information regarding whether the trusts were failing to reimburse Medicare and Medicaid for medical expenditures. The Complaint was filed March 7th in Salt Lake City. A copy of the …
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Medicare Secondary Payer False Claims Act Update

23 Jan 2017 Heather Sanderson No Comments

Blog, Legal/Legislative News, Medicare Jurisdiction, Medicare Secondary Payer News

Lately, we have seen an increase in Medicare Secondary Payer (MSP) False Claims Act (FCA) litigation in Federal courts. Below is an update on two prior existing MSP FCA cases- U.S. ex rel. Kent Takemoto (U.S. Court of Appeals, 2nd Circuit), and Negron v. Progressive (U.S. District Court, New Jersey). Additionally, we have become aware of the now unsealed MSP …
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Blog, Medicare Jurisdiction, Medicare Reporting Section 111

On the heels of CMS’ announcement from May 2016 that it was taking steps to comply with the Medicare Access and CHIP Reauthorization Act (MACRA), which requires CMS to remove SSNs from Medicare ID cards by April 16, 2019, CMS has announced an Open Door Forum call to address how this change would impact Section 111 processes. More information on …
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Blog, Medicare Jurisdiction, Medicare Secondary Payer News

A few months ago, we issued a blog regarding MSP private cause of action litigation against a Plaintiff attorney law firm for failure to reimburse the MAP its conditional payments (Humana v. Paris Blank LLP). For our prior blog on this case, click here. The Paris Blank matter has now settled and the parties are subject to a confidentiality provision.  …
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Blog, Legal/Legislative News, Medicare Jurisdiction, Medicare Secondary Payer News, Pharma Part D, Reimbursements

The Medicare Advocacy Recovery Coalition (MARC) worked diligently over the past eighteen months to develop and introduce the Secondary Payer Advancement, Rationalization and Clarification Act of 2016 (SPARC). Representatives Tim Murphy (18th District Pennsylvania, Republican) and Ron Kind (3rd District Wisconsin, Democrat) sponsored this bipartisan legislation that was immediately referred to the two committees of jurisdiction over Medicare – House …
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CMS Delays WCRC Award to 2nd Quarter of 2017

06 Oct 2016 Heather Sanderson No Comments

Medicare Jurisdiction, Medicare Secondary Payer News

Just last month, CMS issued an updated timeframe Request for Proposal (RFP) for a new Workers’ Compensation Review Contractor (WCRC) bid. This last update stated that the proposal would be released in October 2016, with an award being granted in February 2017. For our prior blog, click here. However, CMS has again updated/delayed their pre-solicitation notice to state that the solicitation …
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Call to Action: The Opioid Epidemic and WCMSAs

09 May 2016 Administrator No Comments

Administration, Blog, Legal/Legislative News, Medicare Jurisdiction, Medicare Set Aside

Franco Signor took an important step last week to inform the White House of a practice by CMS with regard to WCMSAs and the current opioid epidemic.  We have all heard the statistics and agree that action must be taken with regard to overuse and the over prescribing of opioids in the United States.  We applaud the administration’s recent efforts …
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Blog, Legal/Legislative News, Medicare Jurisdiction, Medicare Secondary Payer News, Trial Practice

In an opinion out of the U.S. District Court for the Middle District of Pennsylvania, Mikiewicz v. Hamorski and Erie Insurance Exchange, 2016 U.S. Dist. LEXIS 58859 (May 3, 2016), the Defendant Erie Insurance Exchange (“Erie”) removed the Plaintiff Helen Mikiewicz’s (“Plaintiff”) auto accident litigation to Federal Court. Erie had initiated removal to Federal Court due to the fact that …
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Blog, Legal/Legislative News, Medicaid Third Party Liability Recoveries, Medicare Jurisdiction, Medicare Secondary Payer News, Trial Practice

In an unpublished opinion out of Illinois, McKim v. Southern Illinois Hospital Services, the issue litigated was whether certain government benefit program liens (e.g., Medicare and Medicaid) were capped by state lien law. As expected, the court disagreed, finding that Federal preemption entitled governmental plans like Medicare, Medicaid and Part D to not be subject to limitations imposed by state …
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