Category Archives: Legal/Legislative News

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, 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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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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Blog, Legal/Legislative News, Medicare Conditional Payments

A new decision by the U.S. District Court for the Middle District of Pennsylvania, entitled United States v. Angino, 2019 U.S. Dist. LEXIS 30499 (February 26, 2019), which involves the United States filing a lawsuit to recover conditional payments from the plaintiff attorney, Medicare beneficiary, and “primary plan” caught our attention.  The lawsuit reignites the debate on whether the parties …
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Blog, Legal/Legislative News, Medicare Jurisdiction, Medicare Reporting Section 111, Medicare Secondary Payer News

The Medicare Advocacy Recovery Coalition (MARC) has announced that the Provide Accurate Information Directly (PAID) Act was introduced yesterday, February 27, 2019 in the U.S. House of Representatives as H.R. 1375 by lead Co-Sponsors Reps. Ron Kind (D-WI) and Gus Bilirakis (R-FL). Representatives Kind and Bilirakis have sponsored this bipartisan legislation to improve the Medicare Secondary Payer Act (MSP). PAID’s …
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Blog, Legal/Legislative News, Medicaid Third Party Liability Recoveries, Medicare Secondary Payer News

The following article was co-written by: Roy Franco, Chief Client Officer and Matthew Newman, Associate Compliance Counsel A U.S. District Court’s ruling regarding MSP Recovery LLC’s recent filings in State Court has raised concerns about a possible Medicaid Third Party Liability recovery strategy.  The situation involves an archaic discovery mechanism (“bill of pure discovery”) that would allow MSP Recovery LLC …
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Blog, Legal/Legislative News, Medicare Advantage Part C, Medicare Jurisdiction, Medicare Secondary Payer News

Reprinted from the Morning Consultant In health policy, the minutia is not trivial; it’s essential. Small incentives created by policymakers can have a significant impact upon how Medicare beneficiaries, doctors, hospitals and insurers respond to health care claims. But sometimes policies — even the most well-intentioned — can have unintended consequences, leading to wasted resources, burdensome regulations and broken promises …
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Blog, Legal/Legislative News, Medicare Advantage Part C, Medicare Conditional Payments

Earlier this year, we blogged about an action by MSP Recovery LLC against State Farm being dismissed. Recall that MSP Recovery LLC is an entity out of Miami, Florida that has been filing litigation and class actions nationwide on behalf of Medicare Advantage Plans (MAPs) against primary plans for the alleged failure to reimburse conditional payments to the MAP. For …
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