Category Archives: MSPRC Appeals

Blog, Legal/Legislative News, Medicare Conditional Payments, Medicare Secondary Payer News, MSPRC Appeals

In a decision out of the Southern District of Florida, Shapiro v. Secretary of HHS, 2017 U.S. Dist. LEXIS 42278 (March 23, 2017), the District Court affirmed a final decision of the Medicare Appeals Council (“MAC”) rejecting a Medicare beneficiary’s challenge to Medicare’s conditional payment recovery. The Medicare beneficiary Plaintiff, Barbara Shapiro (“Shapiro”), was injured in an automobile accident with …

Blog, Medicare Conditional Payments, MSPRC Appeals, Trial Practice

Anderson v. Burwell, 2016 U.S. Dist. LEXIS 26633 (March 3, 2016), arises out of the United States District Court for the Eastern District of Michigan, Southern Division.  It raises many interesting Medicare Secondary Payer (MSP) conditional payment reimbursement issues. The background of the case essentially involves a Plaintiff, Roland Anderson, Jr. (“Plaintiff”) who was the personal representative of the estate …

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 …

Blog, Medicare Secondary Payer News, MSPRC Appeals

On Monday, Congressman Tim Murphy for Pennsylvania and Congressman Ron Kind for Wisconsin introduced H.R. #1063 to bring needed improvements to the Medicare Secondary Payer Act.  Long overdue, the proposed legislation builds on the coalition’s previous effort last year when it launched H.R. #4796.  That legislation died last year when the 111th Congressional Session ended on December 31, 2010. H.R. …

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