MEDVAL has published the Official Medicare Set-Aside Blog since 2008. The blog serves a resource for MSA professionals seeking commentary and analysis on the everchanging MSP landscape.
To visit the blog go to www.medicaresetasideblog.com.
The following are highlights from the blog:
Duration of MSAs Just Increased by 0.4 Years
It is supposed to be good news when the CDC tells us that people, as a general proposition, are living longer. However the news isn’t well received when it comes to MSAs
GAO issues preliminary report on Medicare Secondary Payer (MSP) Act
Medicare Secondary Payer: Process for Situations Involving Non-Group Health Plans
GAO-11-726T June 22, 2011
Highlights Page (PDF) Full Report (PDF, 16 pages)
Congress takes on the Medicare Secondary Payer (MSP) Act
On June 22 the Subcommittee on Oversight and Investigations held a hearing entitled “Protecting Medicare with Improvements to the Secondary Payer Regime,” Committee Chairman Cliff Stearns opened with a statement that seriously admonished CMS for its administration of its MSP programs, and truly its lack thereof for the first 20 of the 30 years since the MSP was passed into law….
(Humana v. GlaxoSmithKline) Another MAO Denied Access to Federal Court for MSP Recoveries
On June 13, 2011, the United States District Court for the Eastern District of Pennsylvania dismissed a suit brought by Humana to recover Medicare Advantage (MAO) payments it made on behalf of its enrollees settling Avandia suits with GlaxoSmithKline…
HARRELSON v. ARCADIA – CMS Approval as a Term of Settlement is a “Suspensive Condition”The Court of Appeals of Louisiana recently affirmed a WCJ’s decision to deny a motion for penalties and attorney fees for failure to timely fund an MSA on the basis that the MSA had to first be approved by CMS and then was funded within 30 days of receiving approval notice from CMS. …
Hinsinger v. Showboat Atlantic City – New Jersey Court Decides Attorney’s Fees may be Deducted from MSAs
In an opinion from January 2011, finally released for publication last week, the New Jersey Superior Court ruled that attorney’s fees could be taken from a Medicare Set-Aside….
Haro v. Sebelius – CMS Takes a Beating in Federal Court
We are all painfully familiar with the questionable reimbursement demands of CMS when it comes to Medicare conditional payment recovery: Pay now (and pay all we think you owe) and ask questions later. Last fall CMS lost a little ground in the continued debate about the determining the amount in question, and this month it is the demand for payment before appeal itself that is in question….
Further Support that Medicare Advantage Cannot Pursue MSP Recovery in Court on its Own Behalf
On March 25, 2011, an Arizona US District Court granted summary judgment on the issue of the defendant Medicare Advantage (MA) Plan not having standing to pursue a private cause of action under the MSP….
