Category Archives: Medicare Jurisdiction

Blog, Medicare Jurisdiction

CMS continued its series of webinars on September 17th introducing the CRC to the industry and explaining how it will impact conditional payment recovery processes.  Previously we blogged on the last CMS webinar, but there were additional helpful clarifications in yesterday’s webinar.  To read our last blog, please click here. The information noteworthy of mention on the CRC transition follow: …
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Blog, Medicare Jurisdiction, Medicare Secondary Payer News

We previously issued a blog which discussed the new implementation of a MFA process for the MSPRP. For our prior blog, please click here. Last week, CMS issued a document which provides additional guidance and background information surrounding the RIDP and MFA services. The document can be found here, but a summary of the document follows below. RIDP is the process of …
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More MSP Private Cause of Action “Action”

02 Sep 2015 Heather Sanderson No Comments

Blog, Medicare Advantage Part C, Medicare Jurisdiction, Medicare Secondary Payer News, Medicare Set Aside

A new opinion was just released out of the U.S. District Court for the Southern District of Florida, MSPA Claims 1, LLC v. IDS Property Casualty Insurance Company (August 28, 2015). This case involved MSPA Claims 1, LLC (“MSPA Claims”), as an assignee and on behalf of Florida Healthcare Plus (FHCP), a Medicare Advantage Plan (MAP), pursuing Property Casualty Insurance …
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Blog, Medicare Jurisdiction, Medicare Reporting Section 111

On Tuesday, August 23rd, CMS held a webinar on the transition for Non-Group Health Plans (NGHP) to the Commercial Repayment Center (CRC). A summary follows on how work will be coordinated between the CRC and Benefits Coordination and Recovery Contractor (BCRC) as both will share responsibility for NGHP recoveries.  New process involves new terms, and we highlight them within. As …
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Blog, Legal/Legislative News, Medicare Conditional Payments, Medicare Jurisdiction

CMS issued an alert on August 5th which states the following: On May 9, 2014, the President signed into law the Digital Accountability and Transparency Act (DATA Act). One outcome of this legislation will be to reduce the timeframe for the referral of delinquent debt to the Department of Treasury (“Treasury”) for both Non Group Health Plan (including self-insurance, liability, …
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Blog, Medicare Jurisdiction, Medicare Reporting Section 111, Medicare Secondary Payer News

As part of the Strengthening Medicare and Repaying Taxpayers (SMART) Act, the Centers for Medicare & Medicaid Services (CMS) has implemented optional MFA services which are now available on the MSPRP. MFA is the use of two or more different authentication factors to verify the identity of a user. Verified users will now have access to view unmasked claims data …
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Blog, Medicare Jurisdiction, Medicare Reporting Section 111

CMS has announced that it will be holding a NGHP Town Hall on July 28, 2015 from 1-2 PM EST. The announcement states that CMS will discuss the transition of the NGHP recovery workload to the Commercial Repayment Center during its opening comments. After the opening comments, CMS will address technical and policy questions regarding Section 111 Mandatory Insurer Reporting. …
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Blog, Medicare Jurisdiction, Medicare Secondary Payer News, Trial Practice

A couple of weeks back we reported on the Defendant’s Motion to Dismiss this False Claims Act case (click here to see our prior blog).  This lawsuit brought by the former VP and General Manager of PMSI Settlement Solutions, Kent Takemoto, sought damages from casualty insurers, self insurers, and Third Party Administrators for their failure to comply with the Medicare Secondary Payer …
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Collateral Source Rule Does Not Apply to Medicare Payments

24 Jun 2015 Heather Sanderson No Comments

Blog, Medicare Jurisdiction, Medicare Secondary Payer News, Trial Practice

  In an opinion out of Delaware, Stayton v. Delaware Health Corporation, et.al, 2015 WL 3654325 (June 12, 2015), Delaware’s Supreme Court found that the collateral source rule does not apply to payments made by Medicare. The collateral source rule generally means that a tortfeasor cannot reduce its damages because of payment or compensation received by the injured person from …
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Blog, Legal/Legislative News, Medicare Jurisdiction, Medicare Secondary Payer News, Trial Practice

Franco Signor was invited for oral argument for the MSP False Claims Act case titled Takemoto v. Ace, et. al (Western District of New York) of defendants’ joint motion to dismiss plaintiff’s Amended Complaint before the court held on June 3, 2015. To remind our readers, this False Claims Act case is plaintiff’s (Dr. Kent Takemoto, relator) attempt to recoup …
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