The Official Medicare Set Aside Blog And Information Resource

Ninth Circuit: Guaranty Fund Is Not Deemed a Primary Plan as Related to Non-Covered Claims; States No Obligation to Reimburse Medicare Conditional Payments on Subset of Claims

CMS, Conditional Payments, MSP Litigation, MSP News on October 15, 2019
Posted by Jean S. Goldstein, JD

Last week, the Ninth Circuit United States Court of Appeals issued an important decision involving the Centers for Medicare & Medicaid Services, and the California Insurance Guaranty Fund (CIGA) in Cal. Ins. Guarantee Ass’n v. Azar, Nos. 17-56526, 17-56528, 2019 U.S. App. LEXIS 30339 (9th Cir. Oct. 10, 2019). We last discussed this case in […] Continue

Addition of Open Debt Report Function to the Medicare Secondary Payer Recovery Portal (MSPRP) and Two New Portal User Guides Issued

CMS, Conditional Payments, Medicare Secondary Payer Recovery Portal, MSP News on October 8, 2019
Posted by Jean S. Goldstein, JD

You may have seen our blog post on Friday, regarding an alert from the Centers for Medicare & Medicaid Services (CMS) regarding two upcoming webinars to highlight a new electronic attestation feature on the Workers’ Compensation Medicare Set-Aside portal.  CMS also issued an alert on Friday morning regarding an additional enhancement to the Medicare Secondary […] Continue

First Circuit, Massachusetts Court: Assignee of Medicare Advantage Plan May Bring Private Cause of Action for Double Damages

Conditional Payments, Medicare Advantage, MSP Litigation on July 31, 2019
Posted by Jean S. Goldstein, JD

Earlier this month, the United States District Court for the District of Massachusetts issued a ruling on a Motion to Dismiss and Motion to Strike Class Allegations involving an insurance carrier and a Medicare Advantage Organization (MAO).  The United States District Court for the District of Massachusetts sits in the First Circuit, which includes the […] Continue

Appropriately Administratively Challenging Conditional Payments Saves Insurer from Double Damages

Conditional Payments, MSP Litigation, MSP News on June 26, 2019
Posted by Jean S. Goldstein, JD

Yesterday, an opinion on a familiar case came out of the Sixth Circuit [1].  The case is Duncan v. Liberty Mut. Ins. Co., Civil Action No. 16-CV-12570, 2019 U.S. Dist. LEXIS 106265 (E.D. Mich. June 25, 2019).  You may recall that we discussed this case previously here on our blog in August, 2018.   Last August, […] Continue

Do you Have More Questions About the New Electronic Payment Feature on the MSPRP?

Conditional Payments, Medicare Secondary Payer Recovery Portal, MSP News on April 15, 2019
Posted by Jean S. Goldstein, JD

As you may know, the Centers for Medicare and Medicaid Services (CMS) recently added new functionality to the Medicare Secondary Payer Recovery Portal (MSPRP) allowing electronic payments to be made, as discussed here on our blog.  Last week, CMS issued a document providing answers to frequently asked questions as related to the new functionality.  This […] Continue