Category Archives: Medicare Jurisdiction

Blog, Medicare Jurisdiction, Trial Practice

Following on the heels of Michigan Spine and Brain Surgeons, PLLC v. State Farm Mut. Auto. Ins. Co., 2013 U.S. Dist. (E.D. Mich. 2013) and applying the principles set forth in Bio-Medical Applications of Tennessee, Inc., 656 F.3d 277 (6th Cir. 2011) the Sixth Circuit continues to limit the application of the Medicare Secondary Payer private cause of action – …
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Blog, Medicare Jurisdiction, Medicare Secondary Payer News

Reprinted with permission of Atlantic Information Services, Inc. Texas health system agreed to pay $3.675 million to settle false claims allegations that it ran afoul of Medicare secondary payer rules. Baptist Health System, which owns hospitals in the San Antonio area, resolved allegations that it was overpaid by Medicare from 2003 to 2008, the U.S. Attorney for the Western District …
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Blog, Medicare Jurisdiction

The proliferation of computers, tablets and other devices that increase our productivity can also be a liability as we rely more and more on templates to complete our Release documents.  The following case re-emphasizes the power of the Release when dealing Medicare Secondary Payer issues after a settlement.  What the Parties say, and how clear it is, has consequences.  When …
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Blog, Medicare Jurisdiction, Medicare Secondary Payer News

When I speak about Medicare Secondary Payer Compliance, I am invariably asked the question about my knowledge of any situations where Medicare has enforced penalties under Section 111 of the Medicare & Medicaid SCHIP Extension Act, or otherwise successfully pursued a lawsuit against insurance companies, including self-insurance, for conditional payment reimbursement.   My answer is always “no”, and typically a collective …
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Blog, Medicare Jurisdiction, Medicare Secondary Payer News

Franco Signor is pleased to provide comments on the September 20, 2013, Interim final rule addressing implementation of Title II of the Medicare IVIG and Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act), and specifically implementation of the Section 201 of the Act related to the final conditional payment web portal. CLICK HERE TO READ THE FULL ARTICLE

Blog, Franco Signor News, Medicare Jurisdiction, Medicare Secondary Payer News

On September 20, 2013, CMS issued an interim proposed rule to begin its implication of the SMART law.  The new proposed regulation (42 C.F.R. §411.39  was published in the Federal Register and can be found at Vol. 78, No. 183 or simply click here.  No doubt, CMS has taken a liberal interpretation of what Congress had intended with SMART to …
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Blog, Medicare Jurisdiction, Trial Practice

In the attached disciplinary decision, a public reprimand was issued against an attorney practicing law in the state of Massachusetts.  (READ THE SUMMARY)  The attorney, William R. Dimento, had no prior experience handling personal injury matters, and he was therefore completely unaware of the Medicare Secondary Payer issues in the case.  The injured plaintiff retained Mr. Dimento after she was …
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Blog, Medicare Jurisdiction, Medicare Secondary Payer News

The recent case of Neff v. Sebelius, 2013 U.S. Dist. 143011 (U.S. Dist. Ct. MT), is an example of the importance of jurisdiction in pursuing grievances against the Centers for Medicare & Medicaid Services.  The facts are simple enough in this matter.  Plaintiffs, were non-Medicare beneficiaries and were participants in a global settlement involving asbestos claims.  These 15 plaintiffs presented …
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Administration, Blog, Medicare Conditional Payments, Medicare Jurisdiction

The stalemate in D.C. has now reached the front-line adjuster’s desk.  Non-essential employees for most Federal Agencies have been furloughed and this includes key personnel within the Centers for Medicare & Medicaid Services (CMS) and Social Security Services Administration (SSA)  who work on Medicare Secondary Payer compliance.  CMS contractors that work on Medicare Secondary Payer Compliance are not impacted and …
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Blog, Medicare Jurisdiction, Medicare Secondary Payer News

Today, CMS published its Proposed Interim Final Rule regarding a critical component of the new SMART law.  Effective immediately, a new regulation is effective and the public is invited to comment over the next 60 days.  Thereafter, this rule becomes final unless commentary is such that causes CMS to hit the pause button.    We encourage you to take time to …
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