Category Archives: Medicare Secondary Payer News

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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CMS Issues Technical Alert Regarding Partial SSNs

19 Jun 2015 Heather Sanderson No Comments

Blog, Medicare Reporting Section 111, Medicare Secondary Payer News

Yesterday, CMS issued a technical alert regarding the partial use of SSNs. As mentioned in our prior blog, CMS had recently become aware that the submission of partial SSNs was erroneously causing the return of false positives in matches with regard to Medicare eligibility. The new alert dated June 18, 2015 essentially provides that in order to determine if individuals …
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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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Blog, Medicare Jurisdiction, Medicare Secondary Payer News, MSPRC Appeals

Effective April 28, 2015, Applicable Plans (Workers’ Compensation Law or Plans, Liability Insurance, No-Fault Insurance, and those who self-insure for casualty losses) will be able to appeal erroneous MSP Final Demand Letters directed by the Centers for Medicare & Medicaid Services (CMS) against these entities. This is a significant victory for such Plans and one that should be savored. A …
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Blog, Medicare Secondary Payer News

Today, CMS issued a final rule implementing provisions of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act). The SMART Act requires CMS to provide a right of appeal and an appeal process for liability insurance (including self-insurance), no-fault insurance, and workers’ compensation laws or plans when Medicare pursues a Medicare Secondary Payer (MSP) recovery claim directly from …
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Blog, Medicare Secondary Payer News, WCMSA

Recently, CMS has been busy making small changes that are now reflected in the Updated Guide dated January 5, 2015. We have blogged about these changes as they were originally released. However, they do warrant reiterating. Most notably are: 1. CR13265: Adding language to address schedule change for Hydrocodone compounds from schedule III to Schedule II. Click here to read …
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Blog, LMSA, Medicare Secondary Payer News

Click here to read the recent Computation of Annual Liability Insurance (Including Self-Insurance) Settlement Recovery Threshold report that was submitted to the Congress pursuant to Section 202 of the SMART Act.

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