Category Archives: Blog

Blog, Medicare Conditional Payments

As a continuing effort to update our readers on the Commercial Repayment Center (CRC), we are providing an update on the CRC’s recovery activities. Franco Signor has been notified that several large insurance carriers have received preliminary notice of a large number of potential debts that the CRC intends to issue Conditional Payment Notices (CPNs) or Demands on. Recall that …
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CMS Updates NGHP User Guide with Minor Changes

08 Jul 2019 Heather Sanderson No Comments

Blog, Legal/Legislative News, Medicare Secondary Payer News

As of July 1, 2019, CMS updated its NGHP User Guide to Version 5.6 with Minor Changes. A list of the changes made in the new Guide can be found here. Additionally, the updated Guide can be found at https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Mandatory-Insurer-Reporting-For-Non-Group-Health-Plans/NGHP-User-Guide/NGHP-User-Guide.html. Contact us with any questions at engage@francosignor.com.

Blog, Legal/Legislative News

Over the last several years, we have been providing updates regarding False Claims Act (FCA) litigation, filed both in Federal and NJ court, against Progressive Insurance Company, wherein a whistleblower, a private citizen, asserted that Progressive was not checking Medicare and Medicaid status of its members prior to enrolling them in their health first automobile insurance policies. By not checking …
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Blog, WCMSA

Earlier this year, we blogged about CMS updating its WCMSA Reference Guide. Specifically, we pointed out that CMS for the first time included explicit examples in which the settlements would not meet CMS’ Review Threshold for review of a proposed WCMSA, but which would still require consideration of Medicare’s interests. The first example involved an under-threshold Medicare beneficiary settlement, and …
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Blog, Legal/Legislative News, Medicare Conditional Payments, Medicare Secondary Payer News, Pharma Part D

Several of our clients have been experiencing an increase in conditional payment letters from Medicare Part D prescription drug plans. Historically, Part D plans have been less active in recovery of conditional payments than traditional Medicare or Medicare Advantage Part C plans; however, the tide appears to be changing. Why are Part D Plans recently increasing their recovery efforts? One …
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Blog, Franco Signor News, Medicare Secondary Payer News

2019 has been a particularly active year with regard to enforcement of the Medicare Secondary Payer Act (MSP). The rulemakings on Liability Medicare Set-Asides (LMSAs) and Section 111 penalties are on schedule to be issued in September of this year. Further, the industry has experienced an increase in Medicare Advantage and Part D recoveries, as well as an increase in …
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About Franco Signor, Blog, Franco Signor News

BOSTON, April 24, 2019 – BV Investment Partners (“BV”), a middle-market private equity firm focused on the business services, software and IT services sectors, today announced that it has made an investment in Franco Signor, a provider of Medicare Secondary Payer (MSP) compliance solutions to the country’s largest self-insured companies, insurers, and third party administrators. Franco Signor, headquartered in Bradenton, FL, …
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About Franco Signor, Blog, Franco Signor News, Legal/Legislative News, Medicare Secondary Payer News

Originally published in CLM Magazine April 2019 Edition Following the Rules: Proposed Rules Aim to Clarify Enforcement of Medicare Secondary Payer Compliance In December 2018, two (2) notices were posted on the Office of Management and Budget (OMB) website signaling that the Department of Health & Human Services (DHHS)/Centers for Medicare & Medicaid Services (CMS) plans to move forward with …
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About Franco Signor, Administration, Blog, Legal/Legislative News

BRADENTON, Fla., April 1, 2019 /PRNewswire/ — Franco Signor announced today its new Post-Settlement Administration Services. The service platform is available to injured parties at www.CareMDRx.com. This new platform is designed for individuals that have settled their workers’ compensation or personal injury case and have future medical care needs. Post-Settlement Administration Services are commonly used by individuals who may be …
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Blog, Legal/Legislative News, Medicare Advantage Part C, Medicare Jurisdiction, Trial Practice

Enforcement of the Medicare Secondary Payer (MSP) Act has been increasingly in the news lately, with results that are alarming for both primary plans and plaintiff attorneys. Primary plans beware: Earlier this week, in an decision entitled MSPA Claims v. Tenet out of the U.S. District Court for the Southern District of Florida, the Court dismissed Plaintiff MSPA Claims’ action …
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