The Official Medicare Set Aside Blog And Information Resource

Warning: Another Law Firm Reprimanded for Failing to Repay Medicare Conditional Payments

Compliance, Conditional Payments, Medicare Set-Aside Blog, MSP News on January 9, 2020
Posted by Jean S. Goldstein, JD, CMSP

Yesterday, the U.S. Department of Justice’s Attorney’s Office for the Eastern District of Pennsylvania issued a press release stating that another Philadelphia-based personal injury law firm, has entered into a settlement agreement with the United States to resolve allegations that it failed to reimburse Medicare Conditional Payments.  You may recall we saw a similar action […] Continue

CMS to Host Town Hall Meetings to Discuss Medicare Secondary Payer Recovery Topics

CMS, Conditional Payments, Medicare Set-Aside Blog, MSP News on December 5, 2019
Posted by Jean S. Goldstein, JD, CMSP

The Centers for Medicare & Medicaid Services issued an alert today that it will be hosting two town hall meetings to discuss common Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Ongoing Responsibility for Medicals (ORM) and Group Health Plan (GHP) recovery topics. The first town hall will be held on January 14, 2020 at 1:00 […] Continue

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, Medicare Set-Aside Blog, MSP Litigation, MSP News on October 15, 2019
Posted by Jean S. Goldstein, JD, CMSP

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, Medicare Set-Aside Blog, MSP News on October 8, 2019
Posted by Jean S. Goldstein, JD, CMSP

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, Medicare Set-Aside Blog, MSP Litigation on July 31, 2019
Posted by Jean S. Goldstein, JD, CMSP

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